Academic Conferences in Information Technology Related Issues

CHECKOUT - Place your order ...
 

Please complete the form below.  All data is encrypted and is sent securely to us.
You have TWO PAYMENT OPTIONS: (a) pay online now by credit card OR (b) pay on receipt of invoice

  • If you do not wish to submit your credit card information online, please leave those fields blank and either select "Yes" in the "Invoice Me?" box or call us on +44 (0)1189 724148 after placing your order.

  • Alternatively, print the form and either fax it to +44 (0)1189 724691

  • Or print the form and send it to us with your cheque made out to Academic Conferences International Ltd. A VAT invoice will be sent to you.

Your order will not be complete until you click ‘Submit’ at the bottom of this page.
* Required Fields

 

Title
First and Last Names**
Gender**
Email**
Name of Conference
Are you a Contributing Author?
For Supervisor/Student Bookings - Name of Student
Gender of Student
Email of Student
Student Institution
Student Registration No.
Discount Code (the discount will be applied at invoice)
Organisation Name
Address line 1
Address line 2
Town
County/State
Country
Postcode/Zipcode
Telephone No.
Fax Number
Billing Address (if different)
Billing Address Line 2
Billing Address Line 3
Billing Address Line 4
Additional Information: Please use this box to provide details of a 2nd delegate or any other information you feel we may need in order to process your registration
Invoice Me?
Name of Cardholder
Card Number (we are unable to take Amex or Diners Club)
Switch Issue No. (UK only)
Card security code (last 3 digits on signature strip)
Card Start Month
Card Start Year
Card Expiry Month
Card Expiry Year