JULY 8~10, 2003

ROEHAMPTON UNIVERSITY OF SURREY

STUDENT
REGISTRATION FORM ~ Please print this form, fill-in and return by fax or post to LSA 2003 Administration attn. M. McFee
The Chelsea School, University of Brighton
Eastbourne BN20 7SP (UK) 
FAX from within the UK ~ 01323 644 641
FAX from elsewhere ~ +44 1323 644 641

 Mr / Ms Date
 Course Telephone
Institution Fax
Address and Postcode  Email
HOD NAME  
HOD SIGNATURE,confirming student is not institutionally supported for attendance at this conference  



Please tick Registration Category
and circle the amount as appropriate
 LSA Member Non Member

EARLY To
15 May 2003

LATE After
15 May 2003

EARLY To
15 May 2003

LATE After
15 May 2003
STUDENT Full conference, residential accommodation on site, single room, shared facilities; all meals and refreshments; delegate materials

£185

£185

£200

£200
Student 1 day conference, residential, including accommodation on site, single room, shared facilities if available; lunch, dinner, breakfast and refreshments; delegate materials [INDICATE DAY] July 8
July 9
July 10

£75

£80

£85

£90
STUDENT Full conference, non residential; lunches and refreshments; delegate materials

£75

£80

£85

£90
Student 1 day conference, non residential, including lunch and delegate materials [INDICATE DAY] July 8
July 9
July 10

£40

£45

£50

£60

UK Registrants ~ please PAY by CHEQUE:
I enclose cheque in £ sterling, made payable to "LSA Conference 2003" for amount:  £____________
Other than UK ~ please PAY by CREDIT CARD:
I wish to pay  £_________ by Mastercard / Visa.    Please add £10 for bank charges.
Cardholder name as shown on card
Card Number Expiry Date
Cardholder address Signature

 I wish to join LSA and register for the Conference at the special Member rate

  Contact mcfee@solutions-inc.co.uk      LSA Home Page            Conference 2003 Main Page