International Conference on Post-Cognitivist Psychology

July 4th-6th, 2005, University of Strathclyde, Glasgow, United Kingdom

Supported by the Scottish Branch of the British Psychological Society

Registration Form

Please supply the following details:
Name:		
Address:	
	
e-mail address:		
Daytime phone number:		
Fax:		

Registration Fees:

Entire conference:			£250
Day rates: 	Monday 4th July	£100
		Tuesday 5th July	£150
		Wednesday 6th July	£100

Registration fee for Postgraduate students: 

Entire conference:			£150
Day rates: 	Monday 4th July	£70
		Tuesday 5th July	£120
		Wednesday 6th July	£70

Note: Registration fees include tea and coffee, buffet lunches on Tuesday 5th and Wednesday 6th July, and buffet evening meals on Monday 4th and Tuesday 5th July, but not accommodation.  Lunch is not included on Monday.

Accommodation costs £35 per night for bed and breakfast in student, or £55 per night in local Hotel accommodation if you prefer.

Bed and breakfast accommodation required (please tick as appropriate)	Student accommodation
(£35 per night)	Local Hotel accommodation
(£55 per night)	
Sunday 3rd July			
Monday 4th July			
Tuesday 5th July			
Wednesday 6th July			
Total cost of accommodation:	£…….( pounds/sterling)	£…….( pounds/sterling)	

Grand total (registration fee plus accommodation): £……….(pounds/sterling)

Methods of payment:

1.	Cheque/Bankers draft.
I enclose a cheque/bankers draft (drawn on a British bank) for £……..(pounds/sterling) made payable to University of Strathclyde

2.	Credit/debit card
Please debit my card account with the sum of £……..(pounds/sterling)

Card details:

VISA		ڤ	MASTERCARD		ڤ

SWITCH	ڤ	SOLO		ڤ	DELTA	ڤ

Please note that we do not accept American Express or Diners Club cards.

Card	Number	ڤ ڤ ڤ ڤ   ڤ ڤ ڤ ڤ   ڤ ڤ ڤ ڤ   ڤ ڤ ڤ ڤ

Valid From   		ڤ ڤ/ ڤ ڤ Expiry date	ڤ ڤ/ ڤ ڤ

Issue Number (Switch only)……………………………………………….

Cardholder’s name and initials, as shown on credit card:

……………………………………………………………..(please print name)

Cardholder’s address:
……………………………………………………………………………………..

……………………………………………………………………………………...

Signature of authorised cardholder:

……………………………………………………………..

Date:
…………………………………

Please return this form with payment to:
The Centre for Applied Social Psychology, Department of Psychology, University of Strathclyde, Graham Hills Building, 40 George Street, Glasgow G1 1QE.