Glass Days 2006
Registration Form

Please select the options, printout the completed form, and post or fax to Mrs D Allen (Glass Days 2006), Centre for Mathematical Sciences, Wilberforce Rd, Cambridge CB3 0WA, United Kingdom. Fax +44 1223 765900 to arrive before 31 March 2006 .
Information to appear on your name badge :
First name (and title) :
Last name :
Affiliation :
Contact information :
Postal address :
Post code :
Country :
E-mail :
Office telephone :
Fax :
Contributed papers :	Do you intend to present a paper?   Please select Yes No
	If presenting a paper, please email your title and abstract to glassdays06@damtp.cam.ac.uk by 24 March 2006.
Accommodation :	Single accommodation is available in Wolfson Court, Girton College. Please indicate your requirements.   Please select Nights of 9 and 10 April (£47) Night of 10 April (£32) Nights of 9, 10, 11 April (£70.50) No accommodation required Other. Please specify.
	The conference dinner will be held in Trinity College on Monday 10 April. Do you require a vegetarian meal ?   Please select No Yes
Registration fee :	The registration fee is £80.
Payment :	The accommodation and registration fees must be paid together in pounds (£), and preferably by credit card (using the form below).
Payment method :	Please select Credit card Cheque in Pounds
Total payment (£) :
Credit card information :
Card type :	Please select Visa Mastercard
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Any additional comments :