Registration
Form

SafeComp'97 Registration Form

You can use this form to register for SAFECOMP'97. Print out the form, fill it in, and send it to us by fax or post to the address at the bottom. Because email and web communication is not guaranteed to be secure, we suggest you use fax or post rather than send your registration electronically.

A text only version of this registration form is also available. Click here.

Personal Details

Title:	Family Name:	First name:
Name to appear on badge:
Company/Organisation:
Mailing Address:



Post code:	Country:
Telephone:
Fax:
EMail:

Accommodation

Please tick the type of accommodation you require (prices are are in pounds sterling and are per room, per night).

Single bedroom, ensuite facilities	£31
Standard single bedroom	£22
Twin bedroom, ensuite facilities	£52.80
Standard twin bedroom	£44
Send me information about other types of accommodation in York

Please give the dates you'd like accommodation for, and any special dietary requirements you have while at the conference.

From:	To:	Number of Nights:
Total accomodation cost:
Special dietary requirements:

Registration Fees

Indicate the appropriate category

Early registration (before 8 August 1997)	£295
Late registration (after 8 August 1997)	£350
Speakers and students	£175
Tutorial (before 8 August 1997)	£225
Tutorial (after 8 August 1997)	£275

Please indicate your tutorial choices

First choice tutorial	1	2	3	4
Second choice tutorial	1	2	3	4

Accompanying persons

The registration fee includes the the civic reception on Monday evening and cost of the conference dinner on Tuesday. Additional tickets for the conference dinner are available for accompanying persons, at a cost of £35. Accompanying persons may also attend the reception free of charge, but please let us know.

Number of additional dinner tickets (£35 each):
Number of additional reception tickets:

Payment

Indicate the total amount paid and method of payment.

Total amount paid:

Cheque / Eurocheque / Bank transfer / Credit card

All payments should be made payable to The University of York, by cheque drawn on a UK Bank or by Eurocheque (which must not exceed £700 sterling). Official orders from UK establishments are acceptable provided that the actual order, not just the order number, is sent. Payment may also be made by bank transfer to:

Midland Bank

Parliament Street, York

Account no: 2089 8201

Sort code: 40 47 31

Reference: Computer Science Safecomp'97

Payment may also be made by credit cards: Mastercard, Access, Visa and American Express. Such payments require the following information:

Credit Card type:

Card number:

Card holder's name:

Expiry date:

Amount to be debited in sterling:

Signature:

Address at which the card is registered:

To avoid your bank transfer payment going astray it is essential both to include the above reference with it and to send separate advice of payment with this booking form.