Registration Form - Plasmid Biology 2004

Please complete the form and submit it to: j.barnes.plb@bham.ac.uk .    Please submit a form even if you are sharing a room with another Conference Participant.           The Deadline for Registration is 30th May 2004.   Thank you very much.   
(BACK to Registration Page). 

Please provide the following information:

Full Name (including title):

Organization:

Contact Address:

Email Address:

Telephone Number:

FAX Number:

ACCOMMODATION REQUIREMENTS: Please choose one of the following options  (Required)

Single Room (limited numbers)   

  Shared Room  
                                 (name of roommate if known - ie. another Conference participant)

  Double Room 
                                 (name of accompanying partner - ie person not attending Conference)

DINNER REQUIREMENTS

YES -  I will require dinner on the evenings of: 16th,17th,18 & 19th September 2004.  (Total cost - 60 Euros)

YES - accompanying partner  will require dinner on the evenings of 16th, 17th, 18, 19th September 2004.    
                (ie - partner not participating in Conference)

REGISTRATION:

     Student Registration - 160 Euros