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REGISTRATION FORMCourses on Air Quality9 - 12 September 2013, New Forest, UK

By submitting this form, we understand that you are agreeable to receiving further information from the Wessex Institute of Technology and WIT Press.Your information will be stored on our database and will not be disclosed to third parties.

Title (Prof/Dr/Mr/Mrs): First Name:.. Last Name:..

Organisation: ..

Address: .........

. Email: ...........

Telephone: .... Fax:...........

COURSE FEE in Euros

The course fees include all working materials, lunch, coffee, tea and all computer facilities used, where applicable.

Fundamentals of Air Quality and Climate Change (9 - 11 September 2013) 1750 Nitrogen Compounds in the Troposphere (12 September 2013) 590 Both Courses (9 12 September 2013) 2100

Total Remittance ....

METHOD OF PAYMENT I enclose a cheque made payable to 'WIT' Credit Card: Mastercard / American Express / Visa (please delete those not applicable)Credit Card Number:

Expiry Date:. Card Security Code (3 digit number printed on signature strip):

Credit Card Address / Statement Address (if different from above): ...

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Signature:. Date:...

PLEASE NOTE THAT ALL CREDIT CARD PAYMENTS WILL BE TAKEN IN POUNDS STERLING

Bank Transfer:Bank Details: Natwest, 58 High Street, Lyndhurst, Hampshire, SO43 7ZF, UKBIC/Swift Code: NWB KGB 2LIBAN: GB98 NWBK 6072 1108 7527 02 Euro Account Number: 550 / 02 / 08752702

Please quote delegates' name and Course code Air Quality 13 on all money transfers and if sending a Bankers Draft, pleasefax a copy to us as soon as it is processed.

Please return completed Registration Form to;

J ane Chantler, Course SecretariatWessex Institute of TechnologyAshurst Lodge, AshurstSouthampton, SO40 7AA, UK

Telephone: 44 (0) 238 029 3223Fax: 44 (0) 238 029 2853Email:jchantler@wessex.ac.uk

CANCELLATIONS/REFUNDS

Participants who cancel their registration due to special circumstances more than 60days before the course will receive a complete refund minus fixed expenses. Feesremain payable in full for cancellations received within 60 days of the start of thecourse, even if you are unable to attend or send a representative from yourorganisation. The Institute reserves the right to make changes to the programme thatmay prove necessary. Please check the final programme with the Wessex Institute of

Technology before finalising your travel arrangements.