Conference Application

Applicant *

Address *

Contact Number *

Email *

Pilgrimage *

Role on pilgrimage *

Dietary or other requirements *

Friday meal * If you are coming on Friday, would you like to join us for dinner?

There will be a number of vacancies on the BLMA council - please indicate here if you would be interested in joining council and we will contact you to discuss before the meetings *

Audience questions Please let us know what you would like to get out of the meeting and any specific questions you would like to ask our speakers

Attendance mode - Please tick appropriate boxes and indicate number of tickets for the Conference & Dinner We would advise that delegates try and attend in person as many of our sessions and workshops have been developed with face-to-face fellowship * Would you like to attend in person or virtually

Days attended Please indicate the number of days you intend to join the conference

Dinner on Saturday evening Will you attend and how many tickets would you like?

Direct debit * Would you like to be contacted to set up a direct debit / standing order for your
ongoing membership of BLMA

Costs per person:
Full Conference £80*
Saturday only £60*
Sunday only £30
Conference Dinner £30 in addition to the above please

Delegates will be expected to book their own accommodation with the Prince Rupert or elsewhere if they would prefer.

Payment for the Conference includes 12 months membership of the BLMA.
*As per the AGM in 2021, Annual Memberships now run from November to November, and all standing orders/direct debits outside of November should have been stopped in accordance with this. Those who have a November standing order/direct debit should take £25 off the cost above. Standing orders/direct debits received not in November will be viewed as charitable donations to BLMA.

Please pay by bank transfer to Lourdes Medical Association account number: 20590568. Sort Code: 20-84-13 adding your name as the reference

British Lourdes Medical Association | Lourdes Doctors | Lourdes Nurses | Pilgrimage Medicine

Conference Application

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