Edinburgh, Scotland
Forename: -------------- | Surname: ------------- |
Full-time Student formal attestation included: YES/NO (please delete as appropriate) | **Registration fee you authorise Heriot-Watt to charge you: GBP---------- |
Payment by UK drawn cheque/Visa card/Master Card: (delete as appropriate). Note that a Visa/Master card incurs a 1.75% charge | Email address: |
Signature: | Date: |
**The registration fee you authorise Heriot-Watt to charge you, is what you authorise us to take from your card/send us by cheque (if paying by a UK drawn cheque). This fee should be the correct one for your status (full-time student versus non student) and should be the correct one versus early/late registration. Administration is strict about these factors (early/late, full-time student/non student).
If paying by visa/master card, please fill the next table:
Visa/Master card (delte as appropriate): | Card number (please type in): |
Name of card holder as appears on the card: | Card issue date: |
Card expiry date: | 3 digits security code: |
Signature: | Date: |
Please fill (NO HANDWRITING PLEASE EXCEPT THE SIGNATURE), print and sign the form.
If paying by UK Drawn cheque, please send the signed form with your cheque (payable to "Heriot-Watt University WoLLIC 2008")
to:
If paying by visa, please fax the signed form to: Professor Fairouz Kamareddine, Fax number: +44 131 451 8179
Remember that registration fees are:
Until 15 May 2008 | From 16 May 2008 to 15 June 2008 |
Students: 120 GBP | Students: 170 GBP |
Non-Students: 200 GBP | Non-Students: 300 GBP |