This form will be automatically sent to me when you click the 'send' button at the bottom, but please note that your Email address will not automatically be sent, so it is essential that you fill in the Email address box if you want a reply.

Go Correspondence course 1997, Application Form

Name: Grade:

Email address:

Postal address:

Phone number:

What medium would you prefer to receive the questionnaire in?

  1. By post, on paper.
  2. By post, on 3.5" Floppy disk
  3. By Fax
  4. By Email

If you would like the material in computer readable form, do you prefer:

  1. An html file, with the diagrams as gifs.
  2. A windows write file.
  3. A microsoft works word processor file.
  4. Plain text, with the diagrams as separate files in sgf format.
  5. Plain text, with the diagrams as separate files in sgf format.
Some other form (Please Specify):

Would you like to register for the first phase of the course only, or for both?

  1. First Phase Only
  2. First and Second Phases

Would you prefer to pay by:

  1. UK Sterling cheque (UK Pounds20 for phase 1, UK Pounds70 for both)
  2. US Dollar cheque (US $40 for phase 1, US $140 for both)
  3. Eurocheque (UK Pounds20 for phase 1, UK Pounds70 for both)
Some other method (Please Specify):

To post the form, press this button: .

If you would like to add information not catered for by the form send me an Email

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