|
HISTORIOGRAPHY AND POLITICAL CULTURE
IN TWENTIETH CENTURY IRAN
Conference |
Registration
I
wish to register for the conference and related events
___
Full registration (30 GBP)
___
Academics and students (15 GBP)
(subject
to presentation of proof; payments without proof of concessionary status will be returned)
Registration fee is
inclusive of the conference dinner, but does not include lunch.
Method
of payment:
___
Cheque
(payable to the Iran
Heritage Foundation)
___
Credit
card
Please
debit my credit card (VISA, Mastercard and Amex only)
___
VISA
___
Mastercard
___
Amex
| Card
Number |
________________________ |
| Expiration
Date |
________________________ |
| Name
on Card |
________________________ |
| Signature |
________________________ |
Please
fill in your name and address in block capitals
|
| Name |
________________________ |
| Address |
________________________ |
| City |
________________________
|
| Postcode
|
________________________
|
| Country |
________________________
|
| Tel |
________________________
|
| Fax |
________________________
|
| Email |
________________________
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Please print and return
this form, with UK cheque, banker’s draft in UK sterling or
credit card details to: Historiography Conference, Iran Heritage
Foundation, 5 Stanhope Gate, London W1K 1AH. If paying by credit
card you can also fax your registration to 020 7499 9293.
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