3.

Other Details
Special requirements (e.g. disability, accessibility, dietary):
Request for Car Parking. Car parking is extremely limited in Cardiff. Please select the box to
request a permit, although availability cannot be guaranteed.
I would like to request a parking permit

The Roald Dahl Centenary Conference

Thursday 16th June to Saturday 18th June 2016

Payment Details

Registration form
1. Contact Details

Please select the box for the method of payment:

Title (Prof,Dr,Mr,Mrs,Ms, etc.):

First Name:

Family Name:

Name to Appear on Conference Badge:

Credit card type: MasterCard

other cards)

Address for correspondence:

Credit card number:

Expiry date (mm/yy):

Email:

Cardholders name:

Telephone:

Security code:
(last 3 digits on back of card)

Credit Card

Total
Cost
Payable

Enter
Amount

Registration for Thursday 16th June to Saturday 18th June 2016 (3 days)

180

Student/Cardiff resident rate (whole conference)

95

Registration for individual days (please tick box(es))

90

Student/Cardiff resident rate (individual days)

45

30

15

Thursday 16th June

Friday 17th June

Saturday 18th June

th

Conference banquet (Friday 17 June)

Roald Dahl excursion (Saturday morning)
This will be a tour, led by Cardiff poet Peter Finch and Professor Damian Walford
Davies, of Dahl-related sites in Cardiff. It will involve a fair amount of (easy)
walking and transport by minibus. Tickets will be allocated on a first-come, firstserved basis. (Any overpayment due to this will be refunded.)

Bank Transfer

(Please note that Cardiff University is unable to accept

Date:

CHEQUES or MONEY ORDERS - Cheques must be for the total amount due in pounds sterling. Please
make payable to CARDIFF UNIVERSITY and send to Helen Clifford at the address below. You must
ensure that all bank charges are paid for before payment reaches us, in order to clear the outstanding
amount.
BANK TRANSFER - Bank transfers must be for the total amount due in pounds sterling. You must
ensure that all bank charges are paid for before payment reaches us, in order to clear the outstanding
amount.
Please pay to CARDIFF UNIVERSITY
Account number 70002203
Sort code 08-90-03
Swift code CPBKGB22XXX
Iban number GB33 CPBK 0890 0370 0022 03
Please ensure that the reference says KC3330N004 and your name.
The bank address is:
The Co-Operative Bank plc,16-17 High Street, Cardiff, CF10 1AX, Wales, UK
SEND COMPLETED REGISTRATION FORMS AND PAYMENT DETAILS TO:
Helen Clifford, School Administrator,
Cardiff University, ENCAP, John Percival Building, Colum Drive, Cardiff, CF10 3EU, Wales, UK
You can choose to fax or email forms, see below for contact details
Registration enquiries to Helen Clifford:

Total

Visa

Cardholders signature:

2. Registration

Please choose between the options and enter the relevant amount.

Money Order

CREDIT CARD PAYMENT - Paying by credit card incurs a handling charge of 2% that will be
added to the total amount due.

Affiliation (to be printed on badge):

Conference cost

Cheque

Other enquiries to conference team:

email:
encap-events@cf.ac.uk
Telephone: +442920874293 or 029-2087-4293
Fax:
+442920874502 or 029-2087-4502
email:
DahlConference@cardiff.ac.uk