Iran Heritage Foundation

IRAN HERITAGE FOUNDATION

THE STUDY OF PERSIAN CULTURE IN THE WEST
Sixteenth to Early Twentieth Century
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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.