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).