Course venue and dates:
Surname (Mr/Mrs/Ms/Miss/Dr/Prof):
First name:
Date and country of birth:
Position (if applicable):
Name of organisation (if applicable) and address (including post code and country):
Residential address:
Tel (BH):	Tel (AH):
Mobile tel:	Fax:
Email address:
PAYMENT OPTIONS (please tick preferences) [ ] 790 euros standard fee paid less than two months before the workshop begins [ ] 90 euros discount for "early bird" fees paid in full two months or more before the workshop begins [ ] 140 euros deposit (balance due two months before the workshop begins) [ ] 100 euros discount per person for three or more bookings from the same organisation Enclosed is my fee of _______ euros Payment method: [ ] cheque* [ ] money order* [ ] electronic funds transfer (details available on request) *payable to Peter Spinks
I have read and agree to the conditions of registration as outlined below.
Participant's signature:	Date:

Conditions of registration: * Any booking cancelled two months or more before the workshop begins will be refunded less a 40 euro administration fee; a 20 per cent cancellation fee will apply after this time. * No refund for any cancellation received less than two weeks before the workshop begins. * Cancellations must be in writing. * A substitute is welcome if you cannot attend. * A deposit is forfeited if the balance due is not received more than two weeks before the workshop begins. * Peter Spinks is not liable for circumstances that may force this workshop to be cancelled or postponed. If this happened, participants would be given the option of attending at another time or of a full refund. * All information provided by you on this form is strictly confidential.

Please print out this form, complete it clearly in block capitals and post with your remittance to: Peter Spinks, PO Box 409, Romsey, Victoria 3434, Australia.