To: Cavendish Information Products Ltd
(for and on behalf of the Administrators of the Edward de Bono Millenium Conference)

Please register me for the Edward de Bono Millennium Conference as:
A Contributor - (GBP) £ 12.50
An Observer - (GBP) £ 18.50
A Critic - (GBP) £ 25.00
(Delete as appropriate)

Method of Payment: (please delete where not applicable)
UK Bank cheque  International Money Order  VISA/Mastercard

Name and Address (please include Postal/Zip Code) in capital letters

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email: _____________________________________________

Fax: _________________________

Alias required: YES / NO if 'YES' then Alias:_____________________

Date: ______________ Signature: ________________________

Credit Card details: (Please delete where and if not applicable)
VISA  /  Mastercard
Credit Card Number _____________________________________

Expiry Date: ___________________________________________

Name on Card: ________________________________________

Card Issued By: ________________________________________
Address to which card was issued if different from above:

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