THE
STUDY OF PERSIAN CULTURE IN THE WEST
Sixteenth to Early Twentieth Century
Conference and Related Events | Registration
I
wish to register for the conference and related events
___
Full registration
200 Pounds
___
Academics and students
150 Pounds
(subject
to presentation of proof; payments without proof of concessionary status will be returned)
Registration
fee is inclusive of lunch during the conference, a private tour of the Hermitage and visits to selected sites in and around
St. Petersburg.
Method
of payment:
___
Cheque
(payable to the Iran
Heritage Foundation)
___
Credit
card
Please
debit my credit card (VISA, Mastercard and Amex only)
___
VISA
___
Mastercard
___
Amex
| Card
Number |
________________________ |
| Expiration
Date |
________________________ |
| Name
on Card |
________________________ |
| Signature |
________________________ |
Please
fill in your name and address in block capitals
|
| Name |
________________________ |
| Address |
________________________ |
| City |
________________________
|
| Postcode
|
________________________
|
| Country |
________________________
|
| Tel |
________________________
|
| Fax |
________________________
|
| Email |
________________________
|
Please
print out, complete and return this form, with UK cheque,
banker’s draft in UK sterling or credit card details to:
Hermitage Conference, Iran Heritage Foundation, 5 Stanhope Gate,
London W1K 1AH. If paying by credit card you can also fax your
registration to 020 7499 9293.
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