2023 Registration Form

First Name (required)

Last Name (required)

Name as it will appear on your badge (required)

Billing address (required)

Billing address 2

City/town/village (required)

County or State (required)

Postal or Zip Code (required)

Country

Primary Phone (required)

Secondary phone

email (required)

Are you a commercially published author, publisher, reader, reviewer or agent? (required)
AuthorPublisherReaderReviewerAgent

If you are a commercially published author, who is your publisher?

If you are a commercially published author, what is your website URL?

If you are a publisher, what is the name of your company?

If you are a reviewer, for whom do you review?

If you are an agent, what is the name of your agency?

Would you like to appear on a panel? (Commercially published authors only.)
YesNo

Will you be attending the Gala Events Dinner? (required)
YesNo

If you will be attending the dinner, what is your meal choice? (You will be contacted with more specific options closer to the event, including potential table companions.)
Meat: Confit duck leg, cassoulet sauce, carrots, spinach, and new potatoesFish: Baked seabass, tomato and coriander dressing, celeriac puree, and new potatoesVegetarian: Wild mushroom and potato gnocchi, rocket pesto

If you will be attending the dinner, do you have any dietary restrictions? (You can comment further in the box below.)
YesNo

Ticket Type:
Autumn/winter special: £175Community Pass for UK school and public librarians: £50.00Community Pass for full-time UK students: £50.00Community Pass for recipients of Jobseekers Allowance, Income Support, Employment Support Allowance, Universal Credit, DLA/PIP: £25.00

Are you VAT registered? (required)
YesNo

Payment method (required)
Bank transfer (UK only, preferred option - you will receive an invoice with details)Cheque (UK only - you will receive an invoice with details)Credit card (world wide through Paypal invoice - credit card payments will incur an additional, non-refundable PayPal fee)

Additional comments

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