WEDELMUSIC-2003
On Campus Accommodation Booking

Third International Conference on WEB Delivering of Music
ICSRiM, School of Music, University of Leeds, Leeds LS2 9JT, UK
Web: www.wedelmusic.org/wedelmusic2003 Email: wdm03@leeds.ac.uk

A limited number of basic on-campus accommodations (single room only) are available for
WEDELMUSIC-2003 participants, on a first come first serve basis.

Please complete, sign and return this form by fax to Dr Kia Ng.
FAX: +44 113 343 2586 (International) FAX: 0113 343 2586 (UK)
or FAX: +44 113 343 5468 (International) FAX: 0113 343 5468 (UK)
Family Name (Surname)
...
Name
...
Title (e.g. Ms,Mrs,Mr,Dr,Prof,...)
...
Name of Institution/Company/...
...
Address
...
ZIP-Code/Postal-Code & City
...
Country
...
Telephone
...
Fax
...
Email
...
Web
...

ROOM TARIFF

TARIFF (single room)
bed and breakfast, per night
Standard room (shared toilet)
£35.00 GBP
En suite room
£45.00 GBP
Note: Cancellation one calendar months before the commencement of the conference,
a shortfall charge of £10 per person per night booked will be made. Non-refundable after that.

PAYMENT OPTIONS - PLEASE TICK PREFERRED METHOD OF PAYMENT
.
BY CHEQUE (Only for UK) - Please make your cheque payable to
UNIVERSITY OF LEEDS
.

BY CREDIT OR DEBIT CARD. We are unable to accept American Express Cards
VISA or MASTERCARD: _____________


Please complete the details below using BLOCK CAPITALS
Name and Initials (as appear on the card)
...
Card Holder’s Statement Address
...
House number
...
Address
...
Postal Code / Zip Code
...
Country
...
Security Number (last 3 digits number printed on the signature panel on the back of the card)
...
Day Time Telephone Number
...
Card Number
Valid from
...
Valid to (Expiry/End Date)
...
Please debit my account to the sum of
...
Card Issue No (Debit Cards Only)
...
Card Holder’s signature
Date (dd/mm/yy)
...

Please FAX your complete booking form to
Dr Kia Ng, FAX: +44 113 343 2586 or +44 113 343 5468

……………………………………………………………………………………………………
OFFICIAL USE ONLY

Ref Num
 
Authorisation Number
 

[WEDELMUSIC-2003 home]