Please save my place in ET'97 workshop to be held on the 15th of December at University
College
London's Department of Computer Science.
Title (delete as appropriate): Mr/Mrs/Ms/Dr/Prof/other _____________
Initials: ___ Surname: _________________________________
Organization: ____________________________________________
Address: ________________________________________________
________________________________________________
City: ____________________ Postcode: _________________
Tel: ____________________ Fax: _____________________
Email: _________________________________________________
I am (tick as appropriate):
[_] An academic staff.
[_] A student.
[_] Other.
Enclosed are my registration fees made by cheque payable to University College London
for the amount of £_______ .
Please have an invoice ready for me to collect on the day (tick if appropriate)
[_].
_________________________
_________________________
Signature
Date