PLEASE PRINT THIS FORM AND SEND BY MAIL, WITH CHEQUE TO:

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

The GERARD MANLEY HOPKINS SOCIETY
INTERNATIONAL SUMMER SCHOOL 2008
Monasterevin, Co. Kildare, Ireland tel. 353 45 433613 fax 353 45 434648


July 19 -25, 2008

REGISTRATION Euro 350

(Registration includes attendance at all lectures, workshops, exhibitions, excursions, etc., transport to and from NUI - Maynooth (about 60 Events), 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 Year


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.