New Media and Technological Cultures - Conference Booking Form

Learning Solutions *Developing the Future of Learning*	Priory House 149B Wroslyn Road Freeland Oxfordshire OX29 8HR
E-Mail: rf@learning-solutions.org	Tel: 01993 882087 Fax: 0870 4601132

2nd Global Conference:

Monday 9th August - Wednesday 11th August 2004 Prague, Czech Republic (Please complete one booking form for each person attending)
Click Here to access the payment by Credit Card form. You must complete both the booking form and credit card authorisation form and fax it to Learning Solutions.
Personal Details First Name: ____________________ Surname: _______________ Address: _________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ Country: ____________________ Post/Zip Code_______________ Tel: ____________________ Fax: __________________ E-mail: _________________________________________________
Conference Details Please tick as appropriate. I wish to: ____Present a paper (of no more than 20 minutes duration) ____Chair\participate in a panel discussion ____Conduct a workshop ____Participate in some other way (Please specify):
Conference Payment Calculation Registration Fee The conference registration fee is £115. This includes; registration fee access to e-mail discussion group a copy of the eBook an edition of the hard copy themed volume	Enter amount here: ________
Accommodation Payment Calculation I would like to book accommodation at the Hotel Josef Hotel Bila Labut Check-in Date: __________________ Check-Out Date: _________________ I would like to book; Double (Twin bedded) room Cost: _____ per person person, including breakfast x ________ Nights Single room (1 person only) Cost: _____ per night, including breakfast x ________ Nights	YES/NO YES/NO ________ ________
Total	________
Method of Payment I wish to pay by; _____ Cheque (enclosed/to follow) _____ Bank Transfer _____ International Money Order (enclosed/to follow) _____ Travellers Cheques (enclosed/to follow) _____ Credit Card (subject to 4% surcharge; Amex not accepted) _____ Invoice All cheques to be made payable to: Learning Solutions Please note: all fees must be paid prior to arrival at the conference. Delegates with unsettled invoices will not be granted access to the conference.
Important: Cancellation Policy Before proceeding any further, please carefully read this cancellation notice. By signing this form you consent to accepting the cancellation policy and agree to be bound by its terms. The policy will be rigorously enforced. Cancellation Policy: Cancellation 40 days before the start of the conference = no penalty Cancellation within 40-30 days before the start of the conference = 30% of total costs Cancellation within 29-16 days before the start of the conference = 50% of total costs Cancellation within 15-11 days before the start of the conference = 70% of total costs Cancellation within 10-0 days (including no shows) before the start of the conference = 100% of total costs
Signature _________________________ Please send the form to Dr Rob Fisher at the address shown at the top of the booking form. Thank you very much	Date: __________