REGISTRATION FORM - IoP Particle Physics 2001
University of Southampton 3-5th April 2001

Title...................Surname.................................... Address.............................................................
First Name.......................................................... ........................................................................
Institution............................................................ ........................................................................
......................................................................... ........................................................................
Email.................................................................. Postcode/Zip......................................................
Tel..................................................................... Country..............................................................
IoP Membership Number........................................
Special Requirements (eg: diet, easy access)......... ........................................................................

Conference Presentation Request: parallel talk / poster

Title of Presentation:.........................................................................................


Registration Fee: (circle) includes conference dinner and lunches
IoP member: £120
Non-member: £155 Accompanying Persons: Number ..................
Student member: £30 Extra conference dinners at £25 each ............

Accommodation: Rates are for bed and breakfast in the Highfield hall. Enter number of rooms required for each night.

standard single £25 per night Tue 3rd ........... Wed 4th ...........
ensuite single £35 per night Tue 3rd ........... Wed 4th ...........

Total Amount Payable £__________


Payments by cheque should be drawn on a British bank in £ Sterling payable to University of Southampton.


Full payment must accompany completed registration form. Formal registration will take place only on receipt of the registation fee. Please ensure that all payments are accompanied by your name and are free from all bank charges. Return this form with payment to


Mrs L Hope
IoP Particle Physics 2001
Department of Physics & Astronomy
University of Southampton
Highfield
Southampton SO17 1BJ
UK
Tel:
Fax:
Email:
+44 (0)23 8059 2088
+44 (0)23 8059 3910
iop01@hep.phys.soton.ac.uk