Imperial College of Science, Technology and Medicine

HIGH ENERGY PHYSICS

REGISTRATION FORM

NuFact02 - London 1, 6 July 2002

     Title: 
First Name: 
   Surname: 

Institute Address:


e-mail: 
TEL No. 
FAX No. 

Please BOOK HOTEL ACCOMMODATION with  Conference Office

http://www.ad.ic.ac.uk/conferences/

or Beit Hall accomodation at 

http://www.ad.ic.ac.uk/conferences/nufact.htm

Type of accommodation booked: 

Date of Arrival:   
Date of Departure: 

The conference fee covers the cost of the conference dinner for delegates only.
Additional places may be booked for the conference dinner at a cost of
£ 50 per guest.

No. of Guests for Dinner:   
Food requirements:          

         DEADLINE REGISTRATION:   1 MAY 2002
FEES       Before  1st May 2002:        After  1st May 2002:
SENIORS     £ 200                        £ 230
STUDENTS    £ 150                        £ 180

Add £ 50 for each accompanying guest at the reception and dinner.

METHOD of PAYMENT:

 

Please Note: Payment is due immediately upon completing your registration via this form, not upon arrival at the conference.
Send your payment to the address given below.

UK Cheques should be made out to:  Imperial College, NuFact02

Details for bank transfers:

For payment by bank transfer please also send a fax copy to Piera Brambilla

Please send this form with payment to:
Piera Brambilla,    NuFact02
Physics Dept, Imperial College
Prince Consort Rd, LONDON SW7 2BW

or your Credit Cards info to: p.brambilla@ic.ac.uk 
Tel: 0044 (0)207 594 7824
FAX:  0044 (0)207 823 8830