2012 Registration form

 

                    I wish to register for the DIELECTRIC HEATING course

                        (Microwave and Radio Frequency Heating)

                  to be held at St John’s College, Cambridge, England, UK,

on      …   date to be announced

 

Delegate details

Name:                                       First name:

Position:

Company/Institution:

Address:

 

Zip Code:                        City:                      Country:

Tel:                                 Fax:

E-mail:

 

Human resources contact in your company:

Name:                                       First name:

Company/Institution:

Address:

 

Zip Code:                        City:                      Country:

E-mail:

 

Payment of fee*

Course fee £860                                        

Please invoice me

Please invoice my organization                     

(Please highlight which appropriate)

Contact name for invoice:

E-mail to send the invoice if Company/Institution

     is to be invoiced:

Order number:

 

 

Electronic Signature                                      Date 

 

*Please complete this form and e-mail it to acm33@cam.ac.uk. Alternatively you

can send it to A C Metaxas & Associates at 26 Earl Street CB1 1JR,

Cambridge, England UK.

We will then advise you the procedure for payment by electronic bank transfer

(credit card payment is not accepted).