e-module booking form

Complete this form to sign up for the e-learning MBI module

To book a place on an e-module, fill out this form.
Please register me on the following courses*	Bioproducts Recovery and Loss Successful Biomaterial Transfer, Pumping and Flow Successful Bioreactor Mixing Successful Bioreactor Temperature Management
Desired start date*	dd/mm/yyyy
Title
First name*
Surname*
Gender	MaleFemale
Job title*
Company name*
Company address*
City/state*
Postcode/Zip code*
Country*
Telephone
Fax*
Email*
Purchase Order number (if required)

Terms and conditions: Each course costs £300, which includes online course materials and access to mentoring via email. In addition to purchase orders, we will also accept payment by cheque, payable to 'University College London', crossed 'A/C Payee Only'. Once payment has been received, we will issue you with a username and password enabling you to access the module(s) online for a period of three months from the mutually agreed start date. Cancellation policy: Where notification in writing (including fax) of cancellation is received more than two weeks (14 days) before the starting date of the module, the full fee will be refunded or transferred to a later module or another employee. When notification of cancellation is received in writing (including fax) within less than two weeks (14 days) of the starting date of the course, the fees are not refundable but can be transferred to another employee or module: a transfer charge of 25% of the full course fees will be made; the remainder of the fee will be offset against the cost of the other module of your choice. Please note: University College London reserves the right to cancel any individual module, if it does not attract sufficient interest.
I agree to the terms and conditions*