WEDELMUSIC-2003 REGISTRATION FORM
Third International Conference on WEB Delivering of Music
ICSRiM, School of Music, University of Leeds, Leeds LS2 9JT, UK
Web: www.wedelmusic.org/wedelmusic2003 Email: wdm03@leeds.ac.uk

Please complete, sign and return this form by fax to Dr Kia Ng.
FAX: +44 113 343 2586 (International) FAX: 0113 343 2586 (UK)
or FAX: +44 113 343 5468 (International) FAX: 0113 343 5468 (UK)

Family Name (Surname)
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Name
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Title (e.g. Ms,Mrs,Mr,Dr,Prof,...)
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Name of Institution/Company/...
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Address
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ZIP-Code/Postal-Code & City
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Country
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Telephone
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Fax
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Email
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Web
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IEEE member number
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REGISTRATION FEES. Note: Registration fees include one proceedings, refreshments and
lunches for the full conference days. Registraton fees are non-refundable)

 
Registration fee in British Pounds £
Before 12 June 2003
After 11 June 2003
IEEE member
£320
£390
Non IEEE member
£395
£480
Full Time Student (please fax letter or student-pass as proof of full-time student status)
£110
£180

PAYMENT OPTIONS - PLEASE TICK PREFERRED METHOD OF PAYMENT
.
BY CHEQUE (Only for UK) - Please make your cheque payable to
UNIVERSITY OF LEEDS
.
BY CREDIT OR DEBIT CARD. We are unable to accept American Express Cards
VISA or MASTERCARD: _____________

Please complete the details below using BLOCK CAPITALS
Name and Initials (as appear on the card)
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Card Holder’s Statement Address
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House number
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Address
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Postal Code / Zip Code
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Country
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Security Number (last 3 digits number printed on the signature panel on the back of the card)
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Day Time Telephone Number
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Card Number
Valid from
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Valid to (Expiry/End Date)
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Please debit my account to the sum of
£...
Card Issue No (Debit Cards Only)
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Card Holder’s signature
Date
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Please FAX your complete WEDELMUSIC-2003 registration form to
Dr Kia Ng, FAX: +44 113 343 2586 or +44 113 343 5468

……………………………………………………………………………………………………
OFFICIAL USE ONLY

Ref Num
  
Authorisation Number
  

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