PRINTABLE APPLICATION FORM

Writers & the Internet

16 October 1998

Title (Mr, Mrs, Ms, etc.)…….. Surname…………………………… First Name…………………………………

Position…….………………………………………………………………………………………………..……….

Organisation…………………………………………………………………………………………………..……..

Address…………………………………………………………………………………………………………..…..

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Tel No………..……………………………………….. Fax No…………….………………………………………

E-mail……………………………………….……………… URL ………………………………………………..

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(Concessions apply to students, UB40 holders and senior citizens, proof of status is required)

I enclose a cheque for …………………… payable to ‘Nottingham Consultants Limited’, the trading company

of The Nottingham Trent University.

*Please send me a VAT receipt &127; *I require a vegetarian lunch &127; *Please tick applicable box(es)

The University is committed to improving facilities and services for people with disabilities. Please indicate

any needs arising from a disability which might necessitate additional support or facilities………………………..

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Signed…………………………………………………………… Date……………………………………………..

Please complete and return with your remittance to: Commercial Administrative Centre, The Nottingham

Trent University, Burton Street, Nottingham NG1 4BU. Tel (0115) 948 6409 (direct line),

Fax (0115) 948 6536, email comadmin@ntu.ac.uk