IRAN HERITAGE FOUNDATION

HISTORIOGRAPHY AND POLITICAL CULTURE IN TWENTIETH CENTURY IRAN
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Conference and Related Events |
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. 

 

Copyright © 2004 Iran Heritage Foundation. All rights reserved.
Charity Number 1001785.