Please complete the following booking form if you wish to attend the conference.

THINKING DIFFERENTLY ABOUT AUTISM

23RD November 2018
AMBA HOTEL, CHARING CROSS, THE STRAND, LONDON, WC2N 5HX
Early Bird Discount Price £225 + VAT – if booked before 31 September 2018
Normal price - £265 + VAT

YOUR DETAILS

Your Name (required)

Organisation

Address

Postcode

Telephone No. (required)

Your Email (required)

Please list any dietary or special requirements

PAYMENT DETAILS

Please select how will you be paying?

If you want us to invoice you please complete the following fields

If paying by BACS please make payments to: Nat West Bank PLC, 2 Plymouth Road, Penarth, SSD Ltd t/a Cognitive Centre Foundation Account No 11508582 Sort Code: 54-21-33

If paying by credit card (A member of staff will telephone you to take payment)

Cheques made payable to Cognitive Centre can be sent to: Cognitive Centre,
1st Floor, 34 Cardiff Road, Dinas Powys, Vale of Glamorgan, CF64 4JS

FEES MUST BE PAID IN ADVANCE.

Confirmation will be e-mailed to you within 2 working days of receipt of this form. If confirmation has not
been received after this time, please contact Cognitive Centre 02920 513048 or e-mail [email protected]

Substitutions and Cancellations: Substitutions are acceptable at any time –please let us know if a substitution is to be made. Written confirmation is needed for withdrawn bookings. If a suitable substitute cannot be found cancellation charges will apply.

Cancellation Policy: Over 14 days prior to the event a cancellation fee of £50 will be charged. 7 days or less prior to the event, the FULL registration fee will be charged. We reserve the right to alter or cancel the event due to circumstances beyond our control and accept no responsibility for any costs incurred.