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Leeds International Cardiac MR Course:   ONLINE BOOKING


Enter your details on this page. Your details will be transferred directly to the secure WorldPay website which handles the transfer of funds. Payment methods accepted:

Refunds will be given according to our terms and conditions.
Please note: this form allows online payment to be made with your course registration. If you wish to have a departmental invoice sent to you instead of paying now, please use the form at www.leedcmr.org instead.

Enter your details here:

Which course are you booking on?

Price:
(In addition to the course fee, you may specify accomodation and desire to purchase a discounted Anatomical Atlas of Cardiac MRI Vol. 1 CD-ROM. The CD-ROM is not needed for the course.)

Course fee only (find own accomodation) (£1500.00)
Course fee and discounted CD-ROM (find own accomodation) (total £1635.00)

Course fee and 4 nights accomodation (£1980.00)
Course fee, 4 nights accomodation and discounted CD-ROM (total £2115.00)

Course fee and 5 nights accomodation (£2100.00)
Course fee, 5 nights accomodation and discounted CD-ROM (total £2235.00)
      The extra night is before the start of the course.

      Please also tick this box if you are choosing to buy the CD-ROM:

Full Name:

Title:

Company / Institution:

Profession:

MRI experience:

Cardiac MRI experience:

Which manufacturer do you use?

Website?

Address: (255 characters max)

Country:

Postcode/Zip code:

Telephone:

Fax No.:

E-mail:

Source of funding (e.g. self, employer, etc.):

Any dietary requirements (e.g. vegetarian, vegan):

Hotel room requirements (e.g. non-smoking):

Any other needs or questions? (255 characters max)

...through the WorldPay secure website.

Payment methods accepted:

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