IETA-UK & IRELAND 7th ANNUAL CONFERENCE

SATURDAY 13TH & SUNDAY 14TH OCTOBER 2012

Please send me the following tickets for the IETA-UK 7th annual conference taking place at: The Unicorn Equestrian Trust, Netherswell, Stow-on-the-Wold, Gloucestershire GL54 1JZ Early bird price
(book by 22nd Sept)

No. of tickets

Subtotal

Standard Price 40 40 70 50 50 85

No. of tickets

Subtotal

IETA member 1 day ticket for Sat 13th 1 day ticket for Sun 14 2 day ticket Non member 1 day ticket for Sat 13th 1 day ticket for Sun 14th 2 day ticket Total no. of tickets required Total amount due I would like to have a meal on Saturday evening at the venue (please tick) Name of delegate(s): IETA membership no.(s) where applicable Tick day(s) attending: Sat 13th Sun 14th 40 40 75
th

30 30 Only 50!

[Please continue on separate sheet if necessary.] I enclose a cheque made payable to IETA UK & IRELAND for This includes IETA membership fee; application form(s) enclosed Please give any special dietary requirements: Both lunch and evening meal will be a set menu with a vegetarian choice Your name: Your address: Email: Telephone: Mobile number: Postcode: Email address:

A confirmation with your e-ticket number(s) will be issued once your booking has been processed, along with the conference timetable and directions to the venue. Booking terms
EARLY BIRD DISCOUNT: Bookings need to be received not later than 22nd September for these prices. Members rate applies to student, practitioner & associate membership of IETA worldwide. One ticket per member. JOIN IETA: If you are an ET/VHT/CT student and would like to join IETA to take advantage of the preferential ticket rates for the conference and also gain the additional benefits offered by the Association, please complete page 2 of this form and add the appropriate subscription fee to your total payment.

Please return this form and payment to: IETA- UK & Ireland C/O 23 Hillfoot Road, Shillington, Nr Hitchin, Beds. SG5 3NH.

IETA UK & IRELAND MEMBERSHIP APPLICATION FORM FOR NEW MEMBERS / RENEWALS / UPGRADES

Please complete all sections of the form in BLACK INK and in CAPITALS:
1. Your Details Full name: Address: ! !

Postcode: Tel number:! 2.

! !

Email address:! ! Mobile number: ! Equine Touch VHT Canine Touch

* delete as applicable

Which of the Equine Touch Foundation modalities are you studying/a practitioner? (please tick all that apply):

3.

Please tick which membership type you are applying for/renewing: * Practitioner - 50 per annum Diploma - 30 per annum Student - 30 per annum Associate - 20 per annum (For supporters or non-UK based students) Upgrade to Practitioner - 20 at any point in the year I no longer wish to be a member of IETA-UK

4. 5.

I enclose cheque payment for

Please tick if you require a receipt

For Practitioner renewals only: Please enclose a copy of your current valid insurance certificate plus evidence of OPD undertaken. You need to complete 2 OPD days over each 2 year period. Enclosed Date form sent: Please return your completed form with a cheque made payable to IETA-UK & Ireland to: IETA-UK Memberships, C/o 23 Hillfoot Road, Shillington, Nr. Hitchin, Beds SG5 3NH New membership runs for 12 months from month of application.

6. 7.

Data Protection Act: we will hold your information for sole use in operating IETA-UK & Ireland. No information will be passed to third parties.

Office use only

Mb no.: Folio no.: Date paid: Card issued: Renewal date: Renewal notice sent:
IETA_MM09_Membership_Application_Form_Jul_12.docJul 12

Practitioners only Ins. Cert. no.: Ins. Expiry date: OPD provided:

INTERNATIONAL EQUINE TOUCH ASSOCIATION

UK and IRELAND

The Professional Association of the Equine Touch Foundation Modalities

ST A N D I N G O R D E R M A N D A T E
To: Bank name & address:
(i.e your bank)

The Manager

Please pay:

HSBC 28 High St Oakham Rutland LE15 6AR IETA UK and Ireland Account Number Sort Code Amount 91358669 40-35-21

For the credit of: Bank Details: The sum of:

(In words also)

Commencing on [dd/mm/yyyy] and annually thereafter until further notice , debit my account accordingly:Account to be debited: Account number: Sort code:

Signature: ____________________________________ Date: ________________________________________

This Standing Order Mandate supersedes all previous standing orders to IETA UK and Ireland

www.theequinetouch.com
Version: Feb_09