Fax us your registration for the best literary festival in Ireland

PLEASE PRINT AND COMPLETE THIS FORM.
SEND BY FAX, WITH CHEQUE OR CREDIT CARD DETAILS TO:

The Secretary,
The Gerard Manley Hopkins Society,
Great Connell, Newbridge.
Co. Kildare , Ireland

fax number: 353 45 434648

The GERARD MANLEY HOPKINS SOCIETY
21st INTERNATIONAL SUMMER SCHOOL 2008
Monasterevin, Co. Kildare, Ireland

REGISTRATION Euro 350

(This includes registration, attendance at all lectures, exhibitions, excursions, etc., transport to and from NUI - Maynooth, but does NOT include accommodation or meals)

Title: ____ First name __________Family Name ____________

(please use BLOCK CAPITALS)

Address __________________________

Country __________________________

Postcode __________________________

Tel. number _________ Fax ____________

Email _______________

Payment Details

Credit Card: Visa Mastercard (please tick)

Card Number: Exp. Month Yr

Signed: __________________________________________

Date: ____________________

Will you have a car Y/ N

Would you like us to suggest accommodation? Y/ N

Any special requirements? Y/ N

If YES, please specify: ___________________________

_____________________________________________

The Gerard Manley Hopkins Society a Not For Profit Company limited by Guarantee and approved for Tax Relief under Section 484 of T.C.A. 1997. Sponsors and Donors who wish to avail of this Tax Relief should contact the Society for details. Reg. No:268039. Monasterevin, Co. Kildare, Ireland.