Theoretical 
Archaeology 
Group

Conference Payment Form
Bournemouth University 16th to 18th Dec 1997
Please print this form off and return with remittance in UK pounds by post or FAX before 30th November 1997 to:
    TAG97 Registration 
    School of Conservation Sciences 
    Bournemouth University 
    Talbot Campus 
    Poole 
    United Kingdom 
    BH12 5BB
 or     FAX  (0)1202 59 54 78

Name:    ______________________________________________________________________________

I enclose a cheque (made payable to Bournemouth University in UK £) for the amount:     _________

or

Please charge to my credit/debit card (check whichever is applicable)
 
Mastercard  
 
ACCESS   
 
VISA  
 
Switch  
 
The amount following amount (in UK £)  _______________________________________
 
Card Number
                               
 
Expiry Date:  ____________                                             Issue No (for Switch):  ___________

 Address (for Credit/Debit Card) :  __________________________________________________________

                                                             __________________________________________________________

Country:   ____________________________________________  Post Code:  ___________________
 

Signature: ____________________________________________  Date:  _______________________