ice3

Registration

Name

 

First

Last

Title

   

Affiliation (if appropriate)

 

Institution

Department

   

Address

 

Contact address

Postcode

Billing address if different

   

Details

 

Email

Phone

   

Accommodation

 

Winnock Hotel
total cost £450

Winnock Hotel - postgraduate student rate
total cost £250

I'll organise my own accommodation and transport
total cost £350

   

Special access or dietary needs

 
 
   

Method of payment

 

Cheque

Purchase order

Purchase order number

I'm happy to have my contact details added to the delegate list

   

Any other comments

 
 
   
 
 

Submitting the form constitutes a firm booking and a confirmation will be issued on receipt. Please note that after 1 February 2007 no refunds can be given.

 

 

updated 24 January 2007