General Information
I do want to have my name, including my e-mail address, on the Delegate
List.
(If you do not mark this box, your name will be excluded from the list.)
PLEASE TYPE or PRINT LEGIBLY.
Miss
Ms
Mrs.
Mr.
Dr.
Prof.
First name (as it will appear on your name badge and the participant
list):
Family name:
University:
Department:
Mailing Address:
City:
Province/State:
Country:
Postal/Zip Code:
Phone:
Fax:
Email:
Special Needs (if any):
Audio-visual Supplies/Requirements
I am a presenter; I require the following audio-visual equipment for
my presentation (check as required):
Slide projector
Overhead projector
VHS/VCR
Other (please specify):
Conference Registration Fee
Early Fee (on or before May 31)
Regular Fee (from June 1 and on-site)
Presenter/Faculty/Research Fellow/Other (early: Cdn $150 or US $100; regular:
Cdn $175 or US $115)
Student* (early: Cdn $75 or US $50; regular: Cdn $90 or US
$65)
* A copy of my valid student card is attached/enclosed.
Special Events
Please indicate the number of people planning to attend each special
event:
Welcome Reception at SFU, Harbour Centre:
people (price included in conference fee)
Sherlock Holmes Exhibition, Vancouver Museum:
people x Cdn$10.00 or US$7 =
Friday, Sunset Dinner Cruise:
people x Cdn$68.15 or US$45 .50 =
Total Payment
Cdn dollars or
US dollars
Method of Payment
Cheque or Bank Draft (payable to Simon Fraser University)
VISA (13 or 16 digits)
MasterCard (16 digits)
Sorry, Simon Fraser University does not accept American Express or
Diners Club.
Card No.
Expiry Date
Issue Date (MasterCard only)
Cardholder's Name (if different from registrant above)
Signature (mandatory for credit card)
_________________________________________________________
Payment is due by Wednesday, JUNE 6, 2001