NIOS Conference: NIOS Conference: 12-14 October 2018
Hilton Belfast Templepatrick Golf & Country Club Paradise Walk, Castle Upton Estate, Templepatrick, BT39 0DD Tel: 028 9443 5500
CONFERENCE BOOKING FORM - DELEGATES
Please see the booking link below to book online using the code GOPSA. Guests can either book using the link below or by calling the reservations department and quoting the code GOPSA and dates required. Family bedroom rate will be based on the best available and should be booked directly with the reservations department. There is a special request section for guests to write whether they require the bedroom to be twin rather than double or if there are any other requests that they would like to add.

http://eventsathilton.com/show/5abcc738d4245b537f8f6f1d
Lead Name
Title (Prof, Dr, Mr, Mrs, Ms, Miss) *
Your answer
Full Name *
Your answer
Name of Practice/Hospital/Locum *
Your answer
Postal Address *
Your answer
Post Code *
Your answer
Contact No *
Your answer
Email *
Your answer
Lectures - NIOS Member - Free. Non Member - £50.00 per person per day *
Yes
No
Saturday
Sunday
Lunch *
Yes
No
Saturday Lunch - £10.00 per person
Sunday Carvery Lunch - £15.00 per person
Gala - £30.00 per person *
Yes
No
Attending
Any special dietary/access requirements
Your answer
Partner
Title & Full Name
Your answer
Lectures - NIOS Member - Free. Non Member - £50.00 per person per day *
Yes
No
Saturday
Sunday
Lunch *
Yes
No
Saturday Lunch - £10.00 per person
Sunday Carvery Lunch - £15.00 per person
Gala - £30.00 per person *
Yes
No
Attending
Any special dietary/access requirements
Your answer
Children
Child 1 - please state name, age and any special dietary/access requirements
Your answer
Lunch
Yes
No
Saturday Lunch - £5.00 per child
Sunday Carvery Lunch - £10.00 per child
Child 2 - please state name, age and any special dietary/access requirements
Your answer
Lunch
Yes
No
Saturday Lunch - £5.00 per child
Sunday Carvery Lunch - £10.00 per child
Child 3 - please state name, age and any special dietary/access requirements
Your answer
Lunch
Yes
No
Saturday Lunch - £5.00 per child
Sunday Carvery Lunch - £10.00 per child
Child 4 - please state name, age and any special dietary/access requirements
Your answer
Lunch
Yes
No
Saturday Lunch - £5.00 per child
Sunday Carvery Lunch - £10.00 per child
Costs
Lectures – NIOS Member - Free
Lectures – Non Member - £50.00 per person per day

Lunches

Adults
Saturday Lunch - £10.00 per person
Sunday Carvery Lunch - £15.00 per person

Children aged 5 - 16 ( Kids under 5 years - Free )
Saturday lunch - £5.00 per child
Sunday Carvery Lunch - £10..00 per child

Gala - £30.00 per person

Grand Total
Monies have to be paid in advance
Grand Total - Please total your selections. *
Your answer
Payment details
After completing this booking form, please make payment either by online banking as detailed below or by posting a cheque to 'Northern Ireland Optometric Society', to NIOS Secretary, PO Box 28, Dromore, BT25 1YH.

Bank: Ulster Bank
Account Name: Northern Ireland Optometric Society
Bank Address: 365-369 Ormeau Road, Ormeau, Belfast, BT7 3GP
A/C Number: 37881058
Sort Code: 980145
IBAN: GB 68 ULSB 9801 4537 8810 58
BIC: ULSB GB 2B

Please be reminded that your accommodation is to be booked and paid for directly with the Hotel.
Method of payment (Please pay promptly after completing this form) *
Contact NIOS
PO Box 28, DROMORE, BT25 1YH
secretary@nios.org.uk
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