Berkshire Mathematics

Course Application Form

view appraisals from last years course here

To register complete the form below
or click here to download a copy to print.

Registration
Start date of course
First name
Surname
Home address
Postcode
Home telephone No.
Fax number
e-mail address
School Name
Position
Vegetarian/Special Diet

Accommodation (if required) rates include Dinner and B&B

Whiteknights Hall - standard room with washbasin - £35	17th	18th	19th
Whiteknights Hall - ensuite room - £45	17th	18th	19th
Black Horse House - ensuite deluxe room - £70	17th	18th	19th
Cuisenaire Rods required?			yes
Delegates will require Cuisenaire on the course. A mini-set is available for £12.50. Please submit this form and send a cheque for deposit and postdated cheque for balance.

Payment totals
I confirm that I have sent a cheque for £50 (deposit).
I confirm that I have sent a post dated (1st August 2004) cheque for £240.00 plus the costs of any accommodation and meals plus cuisenaire rods if required
The total for which I am sending a cheque is:

Invoice details
If an invoice is required, please complete above and supply address of account dept. to be invoiced including postcode.	For the attn. of: Address (inc. postcode)

Cancellation Policy: Balance cheque returned if written cancellation
is received by end of July 2004. Refund of deposit will depend on
circumstances, less service charge.

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