Science Communication Conference London,
14 & 15 May 2012
(Fields marked * are mandatory)
  • Details of delegate:
    Title: *
    First name: *
    Surname: *
    Organisation: *
    Job title: *
    Address (line 1): *
    Address (line 2):
    Town/County: *
    Post code: *
    Daytime phone number:*
    Email: *
    To encourage networking, please include a short (max 50 word) description of your involvement in science communication for the delegate pack (only to be circulated to conference delegates)*
    Please tick here if you do not want your contact details and the above paragraph to appear in the delegate list.
    Please tick here if you have not attended the conference before.


  • How would you describe your area of work?
    Science communication is a field which consciously draws on skills and experience from a variety of different sectors. For this reason, we would like to know who is attending the conference.

    Please select one of the categories below. If you are unable to select just one category, you may select more than one or select 'other' and provide your own brief description. *

    Public engagement   Journalism
    Research science   PR & communications
    Engineering   New media
    Social science   Artist
    Industry   Fundraising
    Education   Policymaking
    Student   Government
    Other (please specify)
     

    Concessionary rate
    We are able to offer a concessionary day rate to students and the unemployed. If you believe you are eligible, please tick the appropriate box below and provide the relevant evidence (see pdf for acceptable evidence).

    Student
    Unemployed

    Evidence of status
    No concessionary rate


  • Special Requirements:
    Special dietary requirements:
    Special access requirements:


  • Delegate Monitoring:
    We want to make sure that the conference is accessible to everyone regardless of their age or ethnicity. We would therefore ask you to fill in this part of the application form to enable us to monitor whether the conference is excluding applications from any particular group.

    Age group:

       
    Ethnicity:
    White
    Black or Black British
    Chinese or Chinese British
    Asian or Asian British
    Mixed
    Other ethnic group
    Specify if you wish