Third Age and Leisure Research, Principles and Practice, 16th June 2009 Registration Form

'When I am Old I will wear Purple!' Third Age and Leisure Research, Principles and Practice

16 June 2009 hosted by Buckinghamshire New University, in partnership with the Leisure Studies Association

Deadline for return of booking form:
12th June 2009

Please return form and cheque by post to Sarah Jennings
Wellesbourne Campus, Kingshill Rd
High Wycombe HP13 5BB

I wish to book a place at the " Third Age and Leisure Research" Conference on 16th June 2009 at Buckinghamshire New University
[Prof. / Dr. / Ms. / Mr. ] Name
Address
Email
Telephone
Signed	Date

FEE -- Please tick one option (all options include lunch)
	£35 Individual
	£20 Concessions (students & non waged)
Dietary Requirement, Please state:
Dietary Requirement, Please state:
Method of Payment Please tick one option
	Cheque (attached) made payable to Buckinghamshire New University
	Invoice: Official Purchase Order must be attached to this form
	Credit/Debit Card Payment amount £
	Please debit my: Mastercard, Visa, Maestro (Switch), Electron & Solo (delete as applicable)
	Card Number:
	Expiry Date: Security No. (last 3 digits on the back of the card):
	Valid From:
	Switch Issue No. (if applicable):
	Signature:
	OFFICE ONLY: Authorisation Code(cardholder not present):
Please contact sarah.jennings@bucks.ac.uk for details on local accommodation