Reservation Option (please select appropriate box):**

Select	Option
	Standard Registration £95
	Student discount rate £55

Those seeking discount should provide details of their affiliation

Title:
Ms Mr Dr Professor
First name:**

Last name:**

Institution/Organisation:

Position:

e-mail:**

Address:

Telephone number:

Fax number:

Questions/Special Requirments:

Payment Method:

Invoice my institution:
Full details of position and the address of your institution along with an order number (where appropriate) must be furnished. The payment must be completed before the seminar.

Institution Name:

Institution Address:

Order Number:

Payment by Direct Remittance:
Please print a copy of the form above and mail it along with payment. Payment must be in the form of a cheque from, or a bank draft for, a British bank made out to 'Quality research International'. Direct payment by Electronic Fund Transfer can also be effected thorough banking systems. Please indicate your preference for this method and we will advise you of details.

 ** denotes necessary field