Name:

Title: Dr Prof Mr Ms

Address:

Telephone :    Fax:

Email :

Please complete sections below as appropriate:

1. I wish to attend the symposium and will send my cheque for £275
(Please make cheques payable to "ESBOC" and send to : Professor Tom Simpson, School of Chemistry, University of Bristol, Bristol, BS8 1TS)

2. I wish to apply for a PhD bursary. Enquiries should be addressed to tom.simpson@bristol.ac.uk.

3. I wish to present a short paper (20 min + 10 min discussion).
(Please give a TITLE and brief summary of the paper below).