PUPC APPLICATION FORM

Resident:

^*I wish to attend the above course and require accommodation (bed, breakfast, lunch,evening meal) starting with lunch on the 6 July ending with breakfast on 8 July inclusive. ^*£57.00

Non Resident:

^*I wish to attend the above course and do not require accommodation. ^*£20.00
^*I require luncheon on ^*6/^*7 July @ £3.65 per day. £
^*I require dinner on ^*6/^*7 July @ £5.50 per day. £

Crossed Cheques/Postal Orders should be made payable to the UNIVERSITY OF EXETER and enclosed with the Application Form. No receipt will be issued for cheque payments unless specifically requested.

PLEASE USE BLOCK CAPITALS SPECIFY: ^*STUDENT/TEACHER
Name: Dr/Mr/Mrs/Ms/Miss:
Home Address:

Post Code:
School Address:

Post Code:
Are you staying for the Maths Course? ^*YES/NO

Signature: _____________                           Date of Birth:_________

CANCELLATION: Please note that there will be a cancellation charge of £10 for all cancellations prior to 29 MAY 1998. Thereafter the cancellation charge will be 2/3 of the course fee.

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THIS SECTION FOR TEACHERS ONLY

If accompanying 5 or more students? ^*YES/NO
Please annotate order of preference if you wish to attend:

• Medical Physics Workshop
• Particle Physics Workshop
• Chemistry Workshop

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PUPC Secretary
School of Physics,
University of Exeter
Stocker Road
Exeter EX4 4QL