ICAD'98 Logo

ICAD'98 Registration
Form



When complete send or fax to:
Norma McNaught
ICAD'98 Registrations
Research and Enterprise
University of Glasgow
10 The Square,
Glasgow G12 8QQ
UK
FAX: +44 (0)141 330 5611

Family Name:
First Name:
Academic Title (Prof, Dr, student, etc.):
Institution:
Address:
City:
Post/Zip Code:
Country:
Telephone:
Fax:
EMail:
Name to appear on conference badge:
Which hotel have you booked
(you must book it, this is for our
information only):
Special Requirements:

Tutorials (1/Nov/98)

Please state your preference for the morning and afternoon tutorials:
AM AM PM PM
Tutorial 1 Tutorial 2 Tutorial 3 Tutorial 4
Student (free)
Academic/Industrial (£25 per tutorial)		 1st Choice 1st Choice
1st Choice
 1st Choice

ICAD'98 Conference (2-4/Nov/98)

Please choose one:
Early Registration (Until 21/Sep/98) Late Registration (After 21/Sep/98)
Student
(please include proof of status with your registration)		 £80 £130
Academic/
Academic Related		 £200 £250
Industrial £250 £300

I wish to attend the Civic Reception with the Lord Provost:

The conference dinner is included in the registration.
Additional Conference Dinner tickets for guests (£30 each): £

Tutorial Total (£25 each): £

GRAND TOTAL (Tutorials + Conference): £

Payment

Payment can be made in one of three ways (please choose one):
  1. Cheque made payable to 'University of Glasgow' drawn in Pounds Sterling on a UK clearing bank
  2. Submission of purchase order against which an invoice may be raised
  3. Credit Card. We are only able to accept MasterCard and Visa. Please complete the following details:

    • Name and initials on card:
    • Card holders full address:
    • Card number:
    • Card expiry date:

Declaration

I have read and agreed to your terms and conditions and apply for a place at ICAD'98

Signature:

Date:

Now please send or fax this to the address at the top of the page