About us
Contact us
Display options
SearchSearch this site:

You are not logged in:

www.vitae.ac.uk

researchers for research staff and postgraduate researchers
policy and practicefor staff supporting the development of researchers
supervisors and managersfor those who supervise and manage researchers
employersfor those recruiting and employing researchers

Site Navigation

Breadcrumbs

Home
Courses and events
Advancing in Academia - proposed page
Advancing in Academia 2011 Booking Form

Advancing in Academia 2011 Booking Form

Welcome to the Advancing in Academia 2011 booking form for 12 September. The event is already shaping up to be a fantastic occasion and we look forward to recieving your application.

Your main contact for the course is Michael Duignan.

If you want to talk to someone about the course or anything about this form, please do not hesitate to contact Michael in the courses and events team for further information at Michael.Duignan@vitae.ac.uk or alternatively call on 01223 448 509.

Participant details

Stage of academic career: *

Forname(s) - (please note that this will be the name used on all course literature): *

Surname(s): *

Age (optional):

Daytime number: *

Mobile number: *

Email address: *

Confirm email address: *

Gender: *: Please select
Male
Female

Research Council or funded in any way? If so, please select from our drop down options:: Other, Please specify

Department: *

University / Institution: *

If choosing "other" please give the name of your University/Institution:

Field of study: *

If choosing "other" please give the name of your field of study:

Address line 1: *

Address line 2:

Address line 3:

Postal town / city: *

Postcode: *

Country: *

Dietary requirements:: Other, Please specify

If "other" please state:

Special needs:

If "other" please state:

Do you have a disability?:: Please select
Yes
No

If yes, are there any special needs that we need to be aware of?:

Do you take / are you currently taking any medication?:: Please select
Yes
No

If yes, please give details of medications and any special requirements you may have:

In case of emergency, please give the name and contact number for your next of kin: *

Additional Information

Have you ever been to a Vitae course/event before?: *: Please select
Yes
No

Where did you hear about Vitae?: *

Interested in our other Vitae courses/events but they are not just yet open for booking?

You can register your interest by clicking on the 'Register your Interest - 2011 courses and events' tab on the left hand side of the main Courses and Events page.

www.vitae.ac.uk

researchers for research staff and postgraduate researchers

Site Navigation

Courses and events

Breadcrumbs

Advancing in Academia 2011 Booking Form

Participant details

Additional Information

Interested in our other Vitae courses/events but they are not just yet open for booking?

Postgraduate Researchers

Research Staff

Careers

What's new