Departmental Access £100.00 £17.50 VAT Total £117.50
	Individual Staff Access £50.00 £8.75 VAT Total £58.75
	History Online special offer for Historical Association Members £45.00 £7.87 VAT Total £52.87 Historical Association membership number: _________________________________
	Special Offer (combined School and Student Access) £150.00 £26.25 VAT Total £176.25 Available from January 2000

Please register as follows:

Mr, Mrs, Miss, Ms ______________________________

First name

Surname

Email
We will use email contact, where available

Age range(s) taught: 11-14 14-16 16+

Address (if individual submission)




Cheque enclosed £

Please charge to my credit card

Card holder's name

Card number

Expiry date

Name of school (if school submission)

Please invoice the School:
Official school order number

School address




Daytime telephone number

Facsimile

Please return this form to:
Actis Distribution Centre,
Freepost MID25193
ILKESTON
DE7 5BR

Telephone 0113 944 8330/Facsimile o1279 414130 Email adminonline@actis.co.uk