Booking The Middlesex Hospital, London Celebrations 2019

Booking the All-Day Symposium only

All the tickets for the gala dinner are now sold out.

We can add you to our reserve list so that In the event of a cancellation you can purchase a ticket. Please enter your details in either form below, no payment will be taken for the Gala Dinner, however, you can still book and pay for conference tickets

Gala Dinner Cancellations
No refunds will be reimbursed after 1st August 2019 unless we are able to offer them, and they are accepted, by people on the reserve list.

Please use one of the two booking forms below, depending on how you wish to pay.

Book and pay now will take your booking and online payment or select Book and pay later by cheque or BACS to book now and then pay by cheque or directly into our bank account (BACS) after your booking.

Please use this form if you wish to book and pay now for Symposium tickets securely online as well as add your name to the reserve list for the Gala Dinner

After submitting your order, we will take payment via Paypal. Please note, you are not required to have a PayPal account, but can simply use a debit or credit card.

Name*
First Last
Any other name known by
Address (required to process payment)*
Street Address City County / State / Region ZIP / Postal Code Country
Email*
Phone*
Year you qualified at The Middlesex
If you didn't qualify at The Middlesex, which years did you work there?
Symposium Tickets £60 each
Do you wish to reserve or buy Symposium Tickets?*
I wish to buy Symposium tickets now
I wish to reserve Symposium tickets, dependent on whether I can attend the Gala Dinner
No Symposium tickets required
How many tickets do you wish to reserve, dependent on whether you are successful in securing Gala Dinner tickets?*
Buy Symposium Tickets
Price:
Number of Symposium Tickets to buy
Please enter a number from 0 to 4.
Name of second Symposium guest
Name of third Symposium guest
Name of fourth Symposium guest
Any special dietary requirements for lunch at the Symposium?
Do you require help with Disabled access?
Gala Dinner Reservation List
Gala Dinner Reservation List (you will not be charged at this stage) Quantity
Price:
Tickets will be £70.00 each if successful
Number of Gala Dinner Tickets to add to reservation list (maximum of 2 per person)
Please enter a number from 0 to 2.
Name of second Gala Dinner guest
Payment
Would you like to hear about any future events?*
Yes please
No thanks
Payment will be taken via PayPal where you have the option to pay with a PayPal account or
use your debit/credit card (without the need to set up a Paypal account).
Total
£ 0.00
CAPTCHA
Comments
This field is for validation purposes and should be left unchanged.

Please use this form to book Symposium tickets now but pay later, either by:

Direct transfer into our bank account (BACS) or
Sending a cheque to us

This form may also be used to add your name to the reserve list for the Gala Dinner

One you have submitted your form, you will be given details on how to pay to secure your reserved tickets, which will not be confirmed until we have received payment.

Name*
First Last
Any other name known by
Email*
Phone*
Year you qualified at The Middlesex
If you didn't qualify at The Middlesex, which years did you work there?
Symposium
Do you wish to reserve Symposium tickets now?*
- Yes I wish to reserve and send payment for Symposium tickets now
- No, I wish to reserve Symposium tickets, only if I am able to attend the Gala Dinner
- No Symposium tickets required
How many tickets do you wish to reserve, dependent on whether you are successful in securing Gala Dinner tickets?*
Symposium Ticket
Price:
Number of Symposium Tickets*
Please enter a number from 0 to 4.
Name of second conference guest*
Name of third Symposium guest*
Name of fourth Symposium guest*
Any special dietary requirements for lunch at the Symposium?
Do you require help with Disabled access?
Gala Dinner Reservation List
Gala Dinner Reservation list
Price:
Tickets will be £70.00 each if successful
Number of Gala Dinner Tickets (maximum of 2 per person)*
Please enter a number from 0 to 2.
Name of second Gala Dinner guest*
Any special dietary requirements at the gala dinner?
Do you require help with Disabled access?
Who would you like to sit with on your table?
Do you have any further requirements or questions?
Payment
Would you like to hear about any future events?*
- Yes please
- No thanks
Please select the payment method you intend to use below to secure your reservation. Please note, your reservation is not confirmed until we have received your payment. Please ensure you post a cheque to us by return as we will only keep your reservation for 4 days,
Total now due
£ 0.00
Payment Option*
- I will pay by BACS direct into the bank account
- I will send a cheque
We will give you our bank details to make the payment on the confirmation page after you have submitted this form and also in a confirmation email.
We will give you details on who to make the cheque payable to on the confirmation page after you have submitted this form and also in a confirmation email.
CAPTCHA
Name
This field is for validation purposes and should be left unchanged.

Booking The Middlesex Hospital, London Celebrations 2019

Booking the All-Day Symposium only

All the tickets for the gala dinner are now sold out.

Please use this form if you wish to book and pay now for Symposium tickets securely online as well as add your name to the reserve list for the Gala Dinner

Symposium Tickets £60 each

Gala Dinner Reservation List

Payment

Please use this form to book Symposium tickets now but pay later, either by:

Symposium

Gala Dinner Reservation List

Payment