HISTORIOGRAPHY AND POLITICAL CULTURE
IN TWENTIETH CENTURY IRAN
Conference | Registration

I wish to register for the conference and related events
___      Full registration (30 GBP)
___      Academics and students (15 GBP)
(subject to presentation of proof; payments without proof of concessionary status will be returned)

Registration fee is inclusive of the conference dinner, but does not include lunch.

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 and return this form, with UK cheque, banker’s draft in UK sterling or credit card details to: Historiography 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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Copyright © 2004 Iran Heritage Foundation. All rights reserved.
Charity Number 1001785.