Registration Form 

Name............................................………       Surname……….................................
Address............................................................................................................................
Town.................................................................  Zip Code.......................................................         
Tel…..................................................... Mobile ...................................Fax............................
Educational Institute..................................................................................................   
e.mail..................................................................................................................................

Please reserve two workshops (one for the Monday and one for the Tuesday)
Workshop Advance Booking is compulsory because Workshops are restricted to a maximum of 30 participants!!! 

Sheelagh Deller (Meth)	     �	Sarah Phillips
(YL)	 �	
Simon Marshall 
(TD)	     �	Adrian Underhill (TD)	 �	
John Mc Rae  
(Lit)	     �	Tessa Woodward (TD)	 �	
Peter Medgyes  (Meth)	     �	Jim Wingate 
(TD/YL)	 �	

Mark in order of preference from 1 to 8 	
First come, best served!
Confirmation of booking will be sent via email.

Registration fees:
Euro 80.00 payable with credit card at the Hotel Excelsior La Fonte (conference premises) on arrival.

Please email this form to v.gallerani@dinoto.net