CiE 2006 - Payment Form

If you wish to pay by Cheque then print this form and post it with your cheque, payable to 'UWS', to the address below.


If you wish to pay by Credit Card then complete the following. Note that you can type the information (except signature) directly into the form fields and then print it - however, the entered information will be lost if you save and reload the form.
(Unfortunately, American Express cards cannot be processed by our University.)


Participants Details

Participants Name:
Address:
email:

Payment Details:

Name on Card:
Card number:
Type of card:
End date: Issue no. or security code:

I authorize University of Wales Swansea to charge my card the amount £

Date:
Signature:



Send your completed form (and cheque if applicable) to

CiE 2006
c/o Dr Arnold Beckmann
Department of Computer Science
University of Wales Swansea
Singleton Park
Swansea SA2 8PP
United Kingdom

or you can fax it to: +44-1792-295708.

Receipt will be acknowledged by email