Name *

First Name

Last Name

I am registering as: *

Clinicians and laboratory scientists 

Reduced rate Students, Retirees/Clinicians from low and middle-income countries

Local clinicians working in China

Patient or patient family

Local patients based in China (for patient day only – 4 September)

Pharmaceutical or commercial company representative

Sponsor

Other

Following this workshop, we would like to share publications/reports, workshop presentation materials, abstracts and other information such as details of future workshops, with all participants. This will facilitate future communication and collaboration. Please indicate below your consent for your contact details (name and email address) to be shared with the other workshop participants: *

Yes

No

I would like to be included on an email mailing list held by the organisers of the Alport Syndrome Alliance workshops for future Alport workshop communications *

Yes

No

What type of registration? *

Clinicians, laboratory scientists and other healthcare roles- £440.00

Reduced rate Students, Retirees/Clinicians from low and middle-income countries £175.00

Local clinicians working in China - £140.00

Patient and patient family - £150.00

Local patients based in China (for Patient day only 4 September) Free

Pharmaceutical company representatives not sponsoring workshop - £1500.00

Please give us the name(s) of anyone you think we should invite to the workshop who may not have participated in an Alport workshop before, particularly early career researchers or students:

First Name

Last Name

Authorisation *

I authorise a photographer contracted by Alport Syndrome Alliance and Alport UK to take my photographs.

I authorise Alport Syndrome Alliance and Alport UK to use my photos on Facebook, Twitter, Instagram and other social media platforms.

I authorise a film maker contracted by Alport Syndrome Alliance and Alport UK to include me in recordings at The 2025 International Workshop on Alport Syndrome.

I authorise Alport Syndrome Alliance and Alport UK to use video recordings in which I feature, on Youtube, Facebook, Twitter, Instagram and other social media platforms.

I agree that all intellectual property rights of the photos and videos belong to Alport Syndrome Alliance and Alport UK.

I agree that I will not receive any monetary compensation for usage of my photographs in social media platforms.

Do you need a certificate of participation?

Yes

No