Clinical Research in MRI and Medical Physics

Consent for storing submitted data *

Yes, I give permission to store and process my data

First Name *

Last Name *

Job title *

Department *

Organisation *

Address 1 *

Address 2

Address 3

Town/City *

County/State

Postcode *

Country *

Email Address *

Contact phone *

Are you an IPEM Member?

IPEM Membership Number *

If you are not an IPEM Member, please write NA

Access Requirements

For example, hearing loop, enhanced text on printed or electronic documentation, ground floor access for in person meetings etc.

Booking category

Booking category *

IPEM Member

Retired/Non Salaried IPEM Member

Non Member

Payment method *

Card (payment should be made immediately on submission of your booking form)

Invoice (please ensure we receive your employer Purchase Order within 14 days of booking