WoTUG 21 Registration Form
		Credit Card payment via email version


This document only contains the details to be used for payment by
credit card, suitable for PGP encryption and transmission by email.
For other forms of registration, see the main registration page below
http://www.hensa.ac.uk/parallel/groups/wotug/wotug21/

Registration Form

   Name:
   Organisation:
   Address:





   Post code
   Telephone:
   Fax:
   Email:

   Fee in Sterling (free of VAT) : pick one
   ___ Full fee of £295.00
   ___ Fee with student bursary of £195.00

   ___  Do you want an extra night's accommodation on Saturday 4th (£16.90)?

   Please indicate any dietary or other requirements:


Credit Card Payment Details

   Card type:  ___ Mastercard/Eurocard   ___ Visa
   Card holder's name:
   Card holder's address:



   Credit card number:
   Expiry date (MM/YY):
   (Sorry, no other credit cards are accepted.)


Submission

   Encrypt the above file with the PGP key from
   http://www.cs.ukc.ac.uk/people/staff/djb1/pgp.asc
   and email to D.J.Beckett@ukc.ac.uk

   Registration will confirmed by email from the conference secretary.

   Cancellation by mail or fax is possible subject to a fee of 20% if
   received by March 13th 1998. After that date, no refunds will be made.
   A substitute participant can be named at any time.