Groups St Andrews 2005

REGISTRATION FORM

To: Groups St Andrews 2005
Mathematical Institute
North Haugh
St Andrews
Fife KY16 9SS
Scotland

NAME: (please PRINT) .....................................................................

ADDRESS: .....................................................

......................................................................

EMAIL ADDRESS: ..........................................

Please enrol me as a member of Groups - St Andrews 2005.

Number requiring accommodation ................

Please CIRCLE type of accommodation required DRH Fife Park
NOTE: Prior confirmation required before selecting Fife Park.

Please give expected arrival date ...........................

and departure date ...........................

I enclose the sum of ................ pounds as registration fee(s)
(reduced fee before 31 May 2005).

I enclose the sum of ................ pounds for accommodation

Payment should be made to Groups - St Andrews 2005

If you wish to pay by credit card (Access, Mastercard, Visa only) please use the web facilities
at http://www.groupsstandrews.org/pay.html

Names of accompanying relatives and friends who wish to reserve
accommodation. Please give ages of children under 16.

1. ........................................... 2. ...........................................

3. ........................................... 4. ...........................................

Date: ................................ Signature: ....................................................