Workshop Registration Form

Workshop Registration Form

Name................................................ Address.........................................................

.............................................................................................................

Telephone.....................Fax........................ Email...........................................

*Registration* (includes workshop materials lunch and refreshments)
		No. required	To pay
SETAC member	£95 p.p.		.....................
SETAC non-member	£120 p.p.		.....................

Accommodation (B&B)		Nights*
Standard room	£25 p.p. p.n.	Thu ¨ Fri ¨	.....................
En-suite room	£35 p.p. p.n.	Thu ¨ Fri ¨	.....................

*Indicate which nights you require accommodation for per person (p.p.); per night (p.n.)		Total to pay =	__________________

Payment

Cheques made payable to The University of East Anglia (enclose with this form)

----------------------------------------------------------or

Credit Card: Master/EuroCard¨ Visa¨

Card Number......................Expiry date.....................

CardHolder Name.....................Signature.....................

Please send completed forms to: SETAC, ^C/_O Dr Brian Reid, School of Environmental Sciences, UEA, Norwich, NR4 7TJ.