
Tel: +44 171 975 5217
Fax: +44 181 980 6533
Email: changing-places@dcs.qmw.ac.uk
The web site (http://www.dcs.qmw.ac.uk/research/distrib/Mushroom/workshop/ ) has up to date information about the workshop programme and organisation.
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Changing Places Workshop
- Registration
for the attention
of : Sue White
Affiliation: ____________________________________________
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Affiliation Address:
____________________________________________
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____________________________________________
____________________________________________
Tel:
____________________________________________
Email: ____________________________________________
Delete as appropriate:
* I agree to pay the registration fee of £20
* I qualify for the British HCI Group member rate of £15
British
HCI Group
Membership
Number:__________________________
* I enclose payment : Cheque : £____ Credit card: £____
(Cheques must be
made payable to Queen Mary & Westfield College.)
Special dietary requirements:
______________________________________
Deadline for Registration: Friday 26th March 1999
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Credit Card Payment
Card Holder Name: ____________________________________________
Card Type: ________________ (MasterCard or Visa only)
Card Number: ____________________________________________
Expiry Date: ___/___
Billing Address:
____________________________________________
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Amount: £______