BCA Spring Meeting 1997 - University of Leeds Registration Form
PLEASE CAREFULLY CONSULT THE APPLICATION FORM NOTES WHEN COMPLETING
THIS FORM
1. Personal information
1. Title, initials, surname: ������������������������������
2. Affiliation: ����������������������������������..
3. Address:����������������������������������� ���������������������������������������..
���������������������������������������..
Telephone: ����..�. Fax: ��..����.. E-mail: .���������������.......
Full Student Retired Unemployed BCA member
Non-member
Gender: (circle one) male
female
4. Status (tick one):
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Full
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Student
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Retired
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Unemployed
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BCA member
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Non-member
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5 Supervisors name and signature (Students only): ����������������
2. Registration fees and attendance Schedule:
6 Circle days of attendance:
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Mon.
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Tues.
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Wed.
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Thurs.
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a.m.
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C or B
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P or B or P
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P
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p.m.
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C
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B or I
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Posters
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Circle intended sessions
7. Registration, £120
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9 Surcharge for non-members of BCA (at time of application), add £20
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10 Industrial Group Instrument Sensitivity Workshop: £50
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11 Chemical Group DIRDIF96 workshop: £10
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TOTAL REGISTRATION
FEE: ______
3. Accommodation, etc.
12. Bed and breakfast £22.50 per person per night Circle
nights required: Sun Mon. Tues. Wed.
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13. Lunches, £5.00 per day Circle Lunches required:
Sun. Mon. Tues.
Wed.
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14. Dinners, £10.50 per day Circle dinners required:
Sun. Mon. Tues.
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15. Conference dinner on Wednesday, £25.00
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16. Civic reception on Monday night after dinner: (delete as appropriate)
YES / NO
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TOTAL CHARGE FOR ACCOMODATION ETC: ______
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TOTAL AMOUNT ENCLOSED:
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17. Any special requirements (dietary, wheelchair access, etc.)����������������..
18. I expect to require car parking YES / NO