Wordsworth Summer Conference 2012 Registration Form
We have very few rooms available, so please
consult the Tariff and contact us by
email regarding possibilities
before completing this form.
Then please print this form,
complete
the personal information,
tick where applicable
in the right hand
column,
and mail it to the Conference Administrator:
Stacey McDowell, Department of English, 3-5 Woodland Rd, Bristol University, BS8
1TB.
| Name(s):
|
|
| Affiliation(s) and Status:
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|
| Postal
Address(es):
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| Email address(es): | |
| Telephone: | |
| Please add my/our contact details to the WSC address list | |
| I /we will attend the conference on a non-resident basis | |
| Please book me/us accommodation in price Band A, B, C, D (delete as applicable)† | |
| Please book us an apartment for three people if available / or a family room for three † | |
| Please book me a place at the Youth Hostel Full Board / Half Board (delete as applicable)† | |
| The above accommodation is for Part 1 [the 5 nights of 30 July to 3 August] | |
| The above accommodation is for Part 2 [the 5 nights of 4 to 8 August] | |
| The above accommodation is for Parts 1&2 [the 10 nights of 30 July to 8 August] | |
| I enclose my conference fee of £235 per person | |
| I enclose my half conference fee of £185 per person | |
| I have paid my registration fee online by Google Checkout / I enclose a sterling cheque | |
| I accept responsibility for any cancellation charges as a result of late or non-arrival | |
| I accept the terms and conditions outlined in the prospectus | |
| Dietary requirements: | |
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Signed:
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