Download Ophthalmic Image Analysis Workshop 2 nd December 2011

British Machine Vision Association
Registration form
Ophthalmic Image Analysis Workshop
2nd December 2011, University of Liverpool, UK
Fax, email or post this form to the address shown
Any questions, please call +44 (0) 151 794 4530
Michelle Burns
Department of Electrical Engineering and Electronics
University of Liverpool
Brownlow Hill, Liverpool L69 3GJ
[email protected]
Delegate
Tel: 0151 794 4530
Fax: 0151 794 4540
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Payment (£50 per delegate)
Method of payment  Bank transfer (details below)
 Card payment by telephone
 Cheque (payable to the University of Liverpool)
 On-site payment
Paid by
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BANK NAME:
BARCLAYS BANK PLC
ACCOUNT NAME:
UNIVERSITY OF LIVERPOOL
ACCOUNT NUMBER: 60908533
SWIFT CODE:
BARCGB22
For each BACS transaction, a remittance MUST be sent
Fax number:
+44(0) 151 794 8259
Quote EEG10011 on remittance
Fax
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SORT CODE: 20 – 51 – 01
IBAN NUMBER: GB87BARC20510160908533
for the attention of the Cash Office:
Email:
[email protected]
For directions, visit http://www.liv.ac.uk/maps/visiting