If you have any queries regarding the Conference and your registration, please contact JLC (office@judylaneconsulting.com), Tel: +44 (0)1202 699488.

Registration Form
Title:
First Name: Last Name:
Suffix: Salutation:
Organisation: Position:
 
Address 1: Address 2:
Town/City: County/State:
Zip/Postcode:
Country:
Telephone:Fax:
Email: Secondary Email:
Confirm Email: Confirm Secondary Email:
 
First AIJA Event Please tick if applicable
I am an AIJA Member Please tick if applicable
Accompanying Adults Please tick if applicable
Number
Accompanying Children Please tick if applicable
Number
 
Registration Fees
REGISTRATION CATEGORYFeeTOTAL
Pre-Registration 250.00 EUR
I would like to become a member of AIJA*
Please send me information on future AIJA events*
 
Payment
Please provide your card details to secure your pre-registration.
 
A non-refundable DEPOSIT payment per participant of EUR 250 is required for pre-registration per person.
 
Name on Credit Card:
Card Type: Card Number:
Start Date: / Expiry Date: /
Security Code: Issue Number:
 
Note: A card transaction fee of €10 will be added to your total fees.
 
Data Protection
AIJA Barcelona 2012 will send promotional items, news, conference updates and other information pertaining to AIJA Barcelona 2012. Your information will not be shared with any other company or be used for any other purpose than the planning and promotion of AIJA Barcelona 2012. (office@judylaneconsulting.com)
Yes, I will allow AIJA Barcelona 2012 to send me promotional items

No, please do not allow AIJA Barcelona 2012 to send me promotional items
 

To prevent unauthorised access and maintain data security, Judy Lane Consulting has put in place the appropriate electronic procedures to safeguard and secure the information collected on-line and has made every effort to ensure that all information transmitted online is stored securely.