The Thomas Browne Seminar
Birkbeck College, University of London
Saturday 8th April 2006
Registration Form Click here for a downloadable copy of this form: Word or PDF Please let the organisers know if you are planning to attend: Kevin Killeen K.Killeen@bbk.ac.uk or Karen Edwards K.L.Edwards@exeter.ac.uk
Personal details: name _____________________________________________________ title _____________________________________________________ institution _____________________________________________________ address _____________________________________________________ postcode _____________________________________________________ telephone _____________________________________________________ email _____________________________________________________ special needs _____________________________________________________   Seminar fee and payment details (please tick relevant box): □ Individual (£5.00)  □ Student/Unwaged (Free)     Payment:   To register, please return this form with a cheque made payable to “Birkbeck College” to the address below.  It will also be possible to register on the day of the seminar.  If you would prefer to do so, you can join the mailing list by sending a message to the email address below. Please return to:    Dr Kevin Killeen                                c/o Dr Peter Forshaw                                School of English & Humanities                                Birkbeck, University of London                                Malet Street                                London WC1E 7HX Email:                     k.killeen@bbk.ac.uk