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GCMS Summer Symposium 2013
Title:________________First name:______________Surname:_____________
Cheques to be made payable to “University of Reading”
Cash is also acceptable if submitted in person.
If you would like to pay by credit/ debit card please fill out the details below
(If paying by credit/ debit cards this transaction will incur a 1% surcharge)
Card type (Visa, Mastercard)
Card number (12 to 19 digit number across centre of
card)
Card expiry date
(For Maestro (Domestic) and Solo cards, Card Issue
Number or start date:
Cardholder’s name and initials as they appear on the
card
The ‘Card Security Code’ on the card, which is the
last three or four numbers in the signature strip..
The registered cardholder’s full postal address/billing
address including postcode
Amount to be debited
Cardholder’s signature
Do you require a receipt or not? Yes/No
Please return to:
Amanda Harvey,
Room 163, School of Humanities
University of Reading,
Whiteknights,
Reading,
RG6 6AA
[email protected], [email protected]
tel. 01183787331, fax 01183786440
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