Assist Social Capital

International Conference: Social Capital & Community Resilience
New Lanark, 4th June 2009
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Delegate Name(s)
Name (1)
Name (2)
Name (3)
Name (4)
Contact Name (if different from Delegate)
Organization:
Address:
Postcode:
Email:
Telephone:
Any special requirements? (include access/ dietary requirements):
Payment: Important Notes Bookings will be accepted and confirmed only when full payment has been received. Invoices can be produced if necessary. Members of Assist Social Capital are eligible for a 30% discount. If you are not currently a member but wish to join, subscription rates are as follows: individual Ł10, social economy organisations Ł25, other Ł50. Please submit a separate email applying for membership form with your booking – available here Bursaries - thanks to our sponsors there will be a number of reduced rate places available. Please send us a short email to info@social-capital.net, explaining why you are eligible and why a delegate and / or travel bursary would help you. Deadline for free place applications is 27 of February 2009. Unless specified, the name given will be used for the delegate badges and attendees list. If you DO NOT wish your name, email address and affiliation to appear in the list, please tick this box On receipt of your booking form and payment we will send you an email to confirm your registration.
Payment NB 'Early Bird' - bookings with payment before 30th April 2009 give reduced rates for individuals (Ł50 rather than Ł90) and organisations (Ł120 rather than Ł180)

	Early Bird	Full Cost
Individuals / SMEs / Social Economy	Ł50	Ł90
Statutory Agencies/ Companies	Ł120	Ł180
Member's discount of 30% required
Please tick this box if you are enclosing a cheque payable to 'Assist Social Capital' with this form
If you require an invoice, please provide
Name of organisation
Finance contact name
Invoice address
Telephone
Purchase Order Number