Section 1: Attendee Details

Forename *    Surname *

Position/appointment

Organisation/company

Postal address
*

Postcode/zipcode    Country *

Telephone *    Fax

Email address *

Section 2: Registration Details

For each of the following options please tick your choice. When you click Submit Registration Details the total registration fee will be calculated.VAT is charged at 15% VAT Reg No GB 618 1687 24

Attending 'Real AI' Day (Standard Rate: £75 + VAT)

Attending 'Real AI' Day (Student and Group Booking Rate: £50 + VAT)

Attending Machine Intelligence Competition (No Charge)

Attending Gala Dinner (£35 + VAT) yes no

Vegetarian Option Required? yes no

Special dietary requirements (please specify)

Do you have a disability? yes no
If your answer is yes, please provide details in the 'Any other relevant information' box below.

Any other relevant information

Accommodation
Use of student accommodation at Peterhouse College (£50 + VAT per night)
Please tick for appropriate nights
16th    17th    December 2009

We intend to publish a delegate list, showing names, organisations and email addresses.
If you do not want your details included please uncheck this box

Section 3: Payment Details

Choose Payment Option
Pay by Credit Card (Visa/MasterCard)     Pay by cheque (in pounds sterling drawn on a UK bank)     *

When the above details are all correct, click the Submit Registration Details button below. You will be asked to return a printed copy of the confirmation form with payment details.