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Form Please PRINT and Fax to: +44-(0)131-452-8596 | ||||||||||||||||||||||||
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Delegate's Title: ___________ Name: _____________________________________ Organisation: _________________________________________________________ Address: ____________________________________________________________ ____________________________________________________________________ City: ________________________________________________________________ Post / Zip code: __________________________ Country: ____________________ Tel: _____________________________________ Fax: _______________________ E-mail: ______________________________________________________________ | ||||||||||||||||||||||||
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Please charge £ _______ to my CREDIT CARD account: Visa / Mastercard / Amex (delete) [_][_][_][_] [_][_][_][_] [_][_][_][_] [_][_][_][_] Expiry date [_][_]/[_][_] 3-digit security code: [_][_][_] Cardholder Name and address (if different from Delegate): ___________________________________________________ ___________________________________________________ Date: __________________ Signature: ___________________ | ||||||||||||||||||||||||
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Delegate Cancellation Policy:
before 22nd May 2009 – full refund less £30 administration charge; 23rd
May and thereafter – delegate substitutions accepted, but no refunds
available. | ||||||||||||||||||||||||