Complete and email to avocs05@dcs.warwick.ac.uk. Delete items as appropriate.


Name:

University/Institution: 

Address:






Email:

Phone:

Fax:

I am / am not a full-time student

I require accommodation for the nights of 11th and 12th September / 
I do not require accommodation

I will / will not require dinner on Sunday, 11th September

I will / will not attend the workshop dinner on Monday, 12th September

I will pay by a credit card on the website / I am sending a cheque

Total amount payable:

Dietary Requirements:

Accommodation Requests (e.g. extra nights):

Additional Information: