Centre for Research in Opera and Music Theatre
BOOKING FORM FOR REGISTRATION
ASTONISHED AND TERRIFIED
Please complete and return the following form to [email protected]
Please return as soon as possible
1. CONTACT DETAILS
Surname:
First Name:
Title:
Correspondence
Address:
Tel:
Fax:
E-mail:
Affiliation if applicable:
(University/Institution)
2. REGISTRATION FEES
The registration fees below include attendance at all sessions, general refreshments
including lunch on Saturday 23rd.
We are also organising an informal conference dinner for the evening of the first
www.sussex.ac.uk/cromt
conference day, on Friday 22nd, for which there would be an additional charge.
We are currently still making arrangements for this and will publish costs shortly.
If you already think you may be interested in attending this - a chance for convivial
further conversation we hope - please let Tim know [email protected]
Academic / Arts Professional
£65
Student
£35
Sussex Student
£20
3. PAYMENT OPTIONS
Name:
Signature:
Please choose one of the following options below by ticking the appropriate box and
(where applicable) inserting the relevant information:
A) I would like to pay by Credit/Debit Card
Card Type
Mastercard/Switch/VISA (please specify)
Name on card:
Billing
address:
Card Number
Start
date:
Total amount:
Expiry
date:
Issue
number
(Switch):
3 digit
security code*
(Other Cards):
£
* This is the last three digits on the back of your card. You can send this to the Conference
coordinator separately from this form if you are concerned about data security
[[email protected]].
B) I enclose a Cheque in £ sterling made payable to ‘University of Sussex’
C) I enclose an International Money Order (£ Sterling Only) payable to ‘University of Sussex’
4. DIETARY AND OTHER REQUIREMENTS
All meals will include vegetarian options. Tick here if you
are vegetarian or detail more specialised requirements.
Please inform us if you have mobility or sensory
impairments and give details of specific requirements.
5. TECHNICAL REQUIREMENTS (FOR SPEAKERS ONLY)
Do you require any special technical requirements
(power point, internet access or DVD playback are
provided)?
If yes, please expand:
YES
NO