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Community Network Analysis and ICTs: Bridging and Building Community Ties

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Building & Bridging Community Networks: Knowledge, Innovation & Diversity through Communication

Old Ship Hotel, Brighton , East Sussex , England

31st March - 2nd April, 2004

Registration form in Microsoft Word format

Registration form in Adobe Acrobat (PDF) format

Application form

Please complete then print this form and send it by fax or post to the address below, not via email. If you wish to pay by cheque or credit card, please print this form and fax or mail it to the address below.

Title (e.g. Mr, Ms, Dr)
First name
Surname
Organisation
Address for correspondence
Telephone
Fax
email

 

Requirements
  Accomodation (including all meals) Conference registration Extras
Wednesday 31st March £100 £60 (including lunch)  
Thursday 1st April £100 £60 (including lunch) Conference dinner, £30 (already included in full accomodation rate)
Friday 2nd April £100 £60 (including lunch)  
Conference registration only (meals and accomodation not included)

£150 for all three days

 
Total payable:    

 

Please indicate your method of payment

I wish to pay by credit card and my details are:
Card No.: . . . . . . . . . . . . . . .. ...... ...

Card Type (i.e. VISA, MASTERCARD) .

Expiry Date: . . . . . . . . . . . . . . .........

S i g n a t u r e : . . . . . . .

I enclose a cheque made payable to “University of Brighton”, drawn in pounds sterling on a UK clearing bank.

Please invoice my organisation, I enclose a signed Purchase Order

purchase order number

Individual requirements

Special diet - please specify . . . . . . ..
Wheelchair access...................
Interpreter/signer ..................
Bringing a helper/guide dog....

Further details/notes


Each individual must make a separate application.

For further information and to submit this application, please contact:

Sam Eden-Green

Research Administrator

School of Computing, Mathematical & Information Sciences
University of Brighton
Watts Building
Lewes Road
Brighton
East Sussex
BN2 4GJ

UK

Tel: + 44 1273 642469
Fax: +44 1273 642405

CNAnalysis@brighton.ac.uk

 

  Last modified by Jon Dron April 26, 2005