I wish to register for the conference

_____ Full rate

100 GBP

_____ Consession

80 GBP

_____ Students

40 GBP

Fee covers all conference sessions, evening reception on 29 September, lunch, morning and afternoon tea/coffee on all three conference days. Concession rate for BM Friends, senior citizens, those in receipt of Job Seekers Allowance or Invalid Care Allowance. Student rates for full time registered students. Concession and student rates subject to proof of status. Registration fee is not refundable.

Method of payment

_____ Cheque (payable to IRAN HERITAGE FOUNDATION)

_____ Credit card

Please debit my credit card (VISA, Mastercard & AMEX only)

_____ VISA     _____ Mastercard     _____ AMEX

Cardnumber

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Expiry date

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Name on card

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Signature

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Please fill in your name and address in block capitals

Name

____________________________________

Address

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City

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Postcode

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Country

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Tel

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Fax

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E-mail

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