To complete your event booking, please fill the below form and return to .

COMPANY NAME: Click here to enter text.

CHAIRPERSON/ PRESENTER DETAILS

Name:Click here to enter text.

Job Title:Click here to enter text.

CONFERENCE DETAILS

Date: Click here to enter a date.

Time (UK Time): Click here to enter text.

Duration (Minutes): Click here to enter text.

Lines: Click here to enter text.

Call Title: Click here to enter text.

Cost Centre: Click here to enter text.

Will members of the media be attending the conference? YES☐NO ☐

CALL BOOKER DETAILS

Name: Click here to enter text.

Telephone Number: Click here to enter text.

Email Address: Click here to enter text.

(Event confirmation will be sent to this email address)

PARTICIPANT ENTRY METHOD

Please select the appropriate option below:

Direct Event without Pre Registration☐

(Global list of dial in number provided. Participants will be placed automatically into conference after dialling the participant dial in number and entering the passcode followed by the #key. No participant list information is captured)

Manual Answer☐

(Participants will be greeted by an operator and asked for the conference and their name (and any additional information you have requested). Participants must be advised to start dialing in 10-15minutes prior to the start time. This entry method is not recommended for more for 50 participants)

AUDIO FEATURES

Lecture Only(All participant lines will be muted throughout)☐

Q&A Session (Lecture mode followed by a managed Q&A session)☐

Fully Interactive (All participant lines will be open throughout)☐

Participant List information*(Audio only – maximum of 5 pieces of information)☐

Name: Click here to enter text.

Company: Click here to enter text.

Country: Click here to enter text.

City: Click here to enter text.

Connect/Disconnect Lines: Click here to enter text.

Other: Click here to enter text.

Send to (please enter email address): Click here to enter text.

NOTE: If you have selected Direct Event without registration, we are unable to capture a participant list.

Recordings☐

Please select the format from below:

MP3☐

WAV☐

CD☐

Send to (Please enter address): Click here to enter text.

Encore Replay☐

Available for:

2 weeks☐

1 month☐

Other☐

Please specify: Click here to enter text.

Encore Participant List☐

Name: Click here to enter text.

Company: Click here to enter text.

Send to (Please enter email address): Click here to enter text.

Transcription☐

Please select the turn-around time below:

24 Hour Turnaround☐

48 Hour Turnaround☐

Send to (Please enter email address): Click here to enter text.

Language Requirements☐

Please select a language: Click here to enter text.

Will a Communications Line be required? YES ☐NO ☐

(A communication line is a separate line to the Operator so you can communicate without disturbing the conference itself)

Please state your requirements for the communications line:Click here to enter text.

(E.g. To be used by technicians in the auditorium, used by the call booker as back up)

WEB FEATURES

Web Platform

Please select the appropriate option below:

WebEx☐

Do you require Web Registration?

YES ☐

NO ☐

Web Participant List (Name and Email Address):

YES ☐

NO ☐

Send to (Please enter email address): Click here to enter text.

Would you like the web and audio recorded together?

YES ☐

NO ☐

Send to (Please enter email address): Click here to enter text.

Will you be using a Web Cam?

YES ☐

NO ☐

Will you require Audio Broadcasting (VoIP)?

YES ☐

NO ☐

Please provide the Full Name and Email Address of all persons that are to have Presenter Rights for the web presentation:

Name: Click here to enter text.Email Address: Click here to enter text.

Name: Click here to enter text.Email Address: Click here to enter text.

Name: Click here to enter text.Email Address: Click here to enter text.

Name: Click here to enter text.Email Address: Click here to enter text.

Additional Comments: Click here to enter text.