Book & pay online (Tue 26th to Thu 28th July 2016) EGTA Conference Booking Form Your Details [ * = required info. ]Your name* First name ▲ Last name ▲ Your address* Street address ▲ Town or city ▲ County or region ▲ Postcode ▲ AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country ▲ Your telephone number*Your e-mail address* AccommodationSingleTwinName of the person you will share with* First Last Your ChoicesDietary Requirements Vegetarian Other special dietary requirements Please give details of any dietary requirements:*EGTA Conference Attendance details*Residential, Member (£170)Residential, Non-member (£200)Non-Residential, Member (£125)Non-Residential, Non-Member (£155)Residential includes accommodation, all meals, concerts and events. Non-residential includes all meals, concerts, and events but excludes B&B. Please indicate your requirements in the boxes. If you would prefer to attend only part of the conference please contact the organiser by email and we can look at the cost to meet your individual needs. Total £ 0.00 How do you wish to pay?*Pay direct via BACSPay with PayPalPay by ChequeBACS - Remit appropriate fee to NatWest Acc.No: 82037817, Br.No: 60-21-28, Acc.Name: EGTA(UK), and include your name and 'Conference Booking' in the narrative section. PAYPAL - You can make your payment securely by PayPal using a credit or debit card, even if you do not have a PayPal account. CHEQUE - Please make cheques made payable to "EGTA (UK)" and send to: Ginette Eady, Conference Coordinator EGTA (UK) The Moorings, Horn Lane, New Mill, Holmfirth, HD9 7HG. NameThis field is for validation purposes and should be left unchanged.