International Conference on Post-Cognitivist Psychology

July 4^th-6^th, 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 4^th July £100

Tuesday 5^th July £150

Wednesday 6^th July £100

Registration fee for Postgraduate students:

Entire conference: £150

Day rates: Monday 4^th July £70

Tuesday 5^th July £120

Wednesday 6^th July £70

Note: Registration fees include tea and coffee, buffet lunches on Tuesday 5^th and Wednesday 6^th July, and buffet evening meals on Monday 4^th and Tuesday 5^th 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 3^rd July
Monday 4^th July
Tuesday 5^th July
Wednesday 6^th 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.