Wordsworth Summer Conference 2010 Registration Form
We have very few rooms available, so please 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:
Mrs.
Fiona Gravil, Tirril Hall, Tirril, Penrith CA10 2JE, UK
| Name(s):
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| 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 half board; full board (delete as applicable) † | |
| The above accommodation is for Part 1 [the 5 nights of July 28-August 1] | |
| The above accommodation is for Part 2 [the 5 nights of August 2–6] | |
| The above accommodation is for Parts 1&2 [the 10 nights of July 28–August 6] | |
| I enclose my conference fee of £205 per person | |
| I enclose my half conference fee of £155 per person | |
| I have paid my registration fee online by Google Checkout / by bank transfer | |
| 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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