IUTAM SYMPOSIUM   -   REGISTRATION FORM

Payments must be received no later than 18 December, 2000 and made in sterling either by credit card or by a bankers draft. Personal cheques in sterling are acceptable, but not in foreign currency. Cheques to be made payable to the University of Warwick.


Family Name/Title:  _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

First Name:     _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Institution:    _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Address:        _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

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Tel:            _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Fax:            _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Email:          _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

  Personal cheque enclosed (pounds sterling only)

  Bankers draft enclosed (pounds sterling only)

  Please charge my credit card:      Mastercard    Visa     Total: £ 

Card Number: _ _ _ _ _ _ _ _ _ _ _ _ _      Expiry date: _ _ _ _ _ 

Signature: _ _ _ _ _ _ _ _ _ _ _ _ _ _      Date: _ _ _ _ _ _

Please indicate your requirements below:

  I require the standard deal

  I am staying   _ _   extra nights.   Please give dates: _ _ _ _ _ _ _ _

  I am accompanied by a partner and require an en-suite twin.

  I do not require accommodation.          Any special dietary requirements:

Please return by post or fax to:

Professor Peter W. Carpenter,
School of Engineering, University of Warwick, Coventry, CV4 7AL, England

Fax: (+44) 24-76418922