The 5th International Conference on Contemporary Cast Iron Art
At the world Heritage Site of Ironbridge + Coalbrookdale, Telford, UK April 5th - 9th 2006
PLEASE MAIL THIS FORM ALONG WITH YOUR REGISTRATION FEE
CONFERENCE REGISTRATION PARTICIPANT INFORMATION
Name_______________________________________________ Affiliation (if any) __________________________
Address_____________________________________________________________________________________
City ______________________________________State _____________________ Zip/Postal Code____________
Country_______________________ Daytime Phone (_____)___________________Fax (_____)________________
E-mail_____________________________________Website____________________________________________
REGISTRATION FEE
Postmarked by Jan 20, 2006 Postmarked by Feb 15 2006 On Site Registration
m £175 Professional m £200 Professional m £225 Professional
m £100 Student m £120 Student m £150 Student
m I plan to attend the opening dinner at Blists Hill Victorian Village (Cost £12.50)
m I plan to attend the closing dinner + party (Cost £12.50)
m I am interested in purchasing a T-Shirt : Please Circle your Size XXL XL L M S
m I would like to participate in a pour (affiliation) _______________________________________
m I am interested in the ‘IRON 2006’ Conference Exhibition (Bring a Piece for Exhibition : Drop off on Weds 5th, Pick Up Sun 9th)
Title___________________________________ Dimensions ________________________________
Weight _________________________________ Pedastal/Installation Needs _____________________
m I am interested in the World’s Smallest Cupola Contest (make sure you fill out the additional form on the website)
m I would like to Volunteer to assist in conference activities
m I plan on bringing mold(s). Please state what kind and number of mold(s) Estimated total # of iron weight___________
m Shell (with wax evacuated) _____________ m Sand Mold ________________ m Other (Specify ) __________________
m Total Amt Due £ ___________ Use Currency Converter to Convert UK Pounds (GBP) into Dollars if paying with a US check.
(Please Include all Dinners, Thank You)
m For UK Pounds (GBP) : Make Cheque or International Money Order payable To:
'International Conference on Contemporary Cast Iron Art'
Mail Payment and Completed Registration Form To: Nick Lloyd, Co-Chair,
International Conference on Contemporary Cast Iron Art, The School of Art and Design,
University of Wolverhampton, Molineux Street, Wolverhampton, WV1 1SB, UK.
For US Dollars: Make Check or Money Order payable To: 'International Sculpture Works'
Mail Payment and Completed Registration Form To: Coral Lambert, Co-Chair, ICCCIA,
International Sculpture Works, 55 Clark Street #782, Brooklyn, NY, 11201, USA
Signature________________________________________________________________________________________
For Further Information Check The Website : www.ironbridge06.org Or Email : info@ironbridge06.org