Full Organisation Name:*

Main Contact Title (Mr/Mrs etc) and Full Name:*

Job Title:*

Department:*

Contact Address:*

e-mail:*

Telephone:*

Fax:

* Please see page 2 of this document in order to assign extra contacts to your subscription *

Purchase Order No (if required):

Invoice Address (if different):

The subscription fees quoted below are based on the number of delegate places required for the period and also include the subscribing organisation’s unlimited access to ‘non-event deliverables’ (e.g. website materials and newsletters):

*Subscription Period runs from 1 April 2009 to 31 March 2010 and all prices/places are pro-rata at time of subscription (i.e. the appropriate adjustment will be made to the subscription fee and allocated delegate places at the time of joining).
Extra places for subscribing organisations cost £340 + VAT.

Important: Please ensure you complete this section, as we cannot process your application for subscription until the form has been signed on behalf of the subscribing organisation and the Terms and Conditions of Subscription agreed to.

Please invoice us for this subscription:

From time to time, we may send you information regarding other services offered by the CIPFA group. If you would prefer not to receive this information, please tick the box opposite:

In addition to the main contact, you may also provide us with the details of extra contacts (maximum of 5), to receive service documentation and information on forthcoming events by e-mail, nominated by stream(s) of interest:

5 Streams of Interest =
1. Counter Fraud
2. Risk Management
3. Internal Audit
4. Information Governance, Data Protection and Freedom of Information
5. Ethical Standards

Full contact details should be submitted, as prompted below:

Contact 1

Contact Title (Mr/Mrs etc) and Full Name Stream(s) of Interest Job Title Department Telephone Email Address (if different to main)

Contact 2

Contact Title (Mr/Mrs etc) and Full Name Stream(s) of Interest Job Title Department Telephone Email Address (if different to main)

Contact 3

Contact Title (Mr/Mrs etc) and Full Name Stream(s) of Interest Job Title Department Telephone Email Address (if different to main)

Contact 4

Contact Title (Mr/Mrs etc) and Full Name Stream(s) of Interest Job Title Department Telephone Email Address (if different to main)

Contact 5

Contact Title (Mr/Mrs etc) and Full Name Stream(s) of Interest Job Title Department Telephone Email Address (if different to main)