PSA 2005 :: Registration Form

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> Registration Form

Registration Form

To register for the PSA 2005 conference please complete the following form.

On submission you will be contacted for payment which may be by cheque, bank transfer or credit card. Alternatively, you may download the brochure, print out and fax back the registration form including your credit card details.

Fields in bold are compulsory.

Delegate

or Speaker

Title

First Name

Surname

Address Line 1:

Address Line 2:

Town:

County:

Country:

Postcode / Zipcode:

Telephone

Fax

Email

Dietary Restrictions

Early registration fees apply for payment made on or before 20th June 2005.

Full Conference	£400.00	£475.00
Day Delegate Rate	£200.00	£250
Student Registration	£200.00	£250.00

(Student places are limited and are on a first come first served basis. Supervisor/Head of Department authorisation must accompany students registrations.)

Abstract submission: 01/11/04
Full Paper Submission: 01/07/05
Early registration: 20/06/05

Abstract Title

Poster Titles

I am interested in an exhibition of particle characterisation equipment

I would like to be removed from any database

Please send Travel Bursary application form

Accomodation is available at the Moat House in Stratford. Early booking is recommended as places are limited. Please book directly with the Moathouse Stratford-upon-Avon (www.moathousehotels.com). Please quote PSA2005.

Gala dinner evening will be held on the 22nd September please indicate if you wish to attend.