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					            Relationalities: A Response to Difference
                        Registration Form
             18th May 2010, A115 Samuel Alexander Building, Manchester
     Research Institute for Cosmopolitan Cultures (RICC), University of Manchester
                   http://www.socialsciences.manchester.ac.uk/ricc/

Your Details
  Name:
  Institute/Affiliation:
  (for name badge)
  Address:



  Tel No:                                    Email:

  Would you like to receive email information of RICC’s future events? Yes           No

Registration for Lunch
(Registration for this event is free and includes tea and coffee at no cost. If you require lunch, we
are asking for a contribution of £10 to cover costs. There are other cafes available on campus if
you do not wish to contribute this amount )
  Places are limited so early registration is advised

  I wish to have lunch provided by RICC: £10
  Any special dietary requirements? _________________________________________

  Payment method:           Cheque (made payable to University of Manchester)
                            Credit card (please fill in attached credit card form)

  Please note: Final deadline for registration is 1st May

Accommodation

  Accommodation options for self-booking can be found on the website.

                               Return this form by post or email to:
   Caitriona Devery, RICC, Arthur Lewis Building (2nd Floor), Oxford Rd, Manchester, M13 9QH.
                  Email: caitriona.devery@manchester.ac.uk Tel 0161 2754793
CREDIT/DEBIT CARD RECEIPT                                    FOR INCOME OFFICE USE
CUSTOMER NOT PRESENT                                                    Receipt Number:

                                          TO BE FILLED IN BY UNIVERSITY DEPARTMENT HOLDING EVENT

DEPARTMENT OF                        SoSS (Research Institute for Cosmopolitan Cultures)

CONTACT NAME AND TEL NO              Caitríona Devery 0161 2754793

DESCRIPTION OF CONFERENCE Relationalities: A Response to Difference, University of Manchester

Please attach an addressed pre paid envelope if you require a receipt

FINANCE CODE TO BE CREDITED                                     SOURCE OF FUNDS

A    A    0     7    6     5    0     1    5    0     2
                                                                                  FOR INCOME OFFICE USE ONLY
REASON RETURNED

     The card has been declined                   The card has expired              The card number is invalid


    Valid from/Expiry date missing                No Issue Number               No Finance Code
quoted/Finance Code invalid

American Express/Discover Card The PDQ machine is not accepting the card
 Other reason ………………………………………………………………….
CUSTOMER DETAILS                                                          TO BE FILLED IN BY THE CUSTOMER

NAME ON CARD                        ……………………………………………………………………….……..

CARDHOLDERS ADDRESS                 ………………………………………………………………………..…….
(per statement)
INC POSTCODE                        …………………………………………………………………

CONTACT TELEPHONE                   ………………………………………………………………………………

CONTACT E MAIL ADDRESS ……………………………………………………..………………………..

AMOUNT £ ……………………….                             CARDHOLDERS SIGNATURE: …………………………….


--------------------------------------------------------
                                                                         TO BE FILLED IN BY THE CUSTOMER

CARD ISSUED BY (BANK OR EQUIVALENT) ………………………………………………………………

CARD NUMBER (On the front of the card)………………………………………………………….…………..

SECURITY NUMBER :( On the back of the card) ……………………………………………………………….

CARD TYPE: VISA………………………….…….                          MASTERCARD………………………………………

                MAESTRO………………………….... CARD ISSUE NUMBER…………………………..…

                VISA/DELTA……………..………..                 JBC………………………………….…………………

                 SOLO………………….……………. CARD ISSUE NUMBER…………………………..…

VALID FROM DATE (MM/YY)………………………EXPIRY DATE (MM/YY) ……………………….….

CARD DETAILS TO BE DETACHED AND DESTROYED AFTER TRANSACTION COMPLETION

				
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