Non-Student Registration

New Registration Data

:: Personal

Peer Biography*

Words Left

Your Picture Upload

Mobile Phone Number

On which you can be contacted on site

Country Code	Main Number

:: Your Laptop

Will you be bringing your own laptop computer?*	YesNo
Wireless MAC Address*
Wired MAC Address*

:: Special Needs

specialRequirements*	YesNo
Please specify your requirements*	Words Left
dietaryRequirements*	YesNo
Please specify your requirements*	Words Left

:: Language Skills

Native Language*
English Language (Spoken Interaction)*
Additional Language 1*
Spoken Interaction*
Additional Language 2*
Spoken Interaction*
Additional Language 3*
Spoken Interaction*

:: Guests

Will you be bringing a guest?*	YesNo
Guest Name*
Room Allocation*	Separate RoomSharing Your Room
Arrival Date*
Estimated Time of Arrival*

:: Travel Accommodation

SharedOrPrivateRoom*	SharedPrivate
If shared, with whom would you like to share?*
Travel Accom 1
Arrival Date*
Estimated Time of Arrival*
Travel Accom 2
Arrival Date*
Estimated Time of Arrival*
Travel Accom 3
Arrival Date*
Estimated Time of Arrival*

:: Roles for non-student

P.C. Member*	YesNo
Presenter*	YesNo
Tutor*	YesNo
Admin - Support*	YesNo
TechSupport*	YesNo
Other*	YesNo
OtherStudentRoles*	Words Left

Data Carried Forward from Appplication For Students / Newly Entered for Non-Students

:: Contact Information

Other

Additional Items if you include 'other' above.

Should your email be visible to students?*

YesNo

Home/Work Phone Number*

Country Code	Main Number

:: Institution Information

Institution Name*

(be as specific as possible, e.g. University of Edinburgh, UK)

Department Name*

(be as specific as possible, e.g. Department of Physics)

Website

:: Final Submission

Final Submission

:: Contact email