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This registration form requires that JavaScript is enabled in your browser! Please enable JavaScript in your browser, or switch to a compatible web browser, so you can use the registration form. For more information on how to resolve this problem, see
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Course Cancellations
Online Registration Form
Price category
Price
*
Title
*
(Mr/ Mrs/ Miss/ Dr / Ms)
First Name
*
Surname
*
Department
*
Position
Doctor
Nurse
Med Student
Nurse Student
AHP
Admin/Non Clinical
*
Delegate Type
Internal
External
*
Mobile No
*
Email
*
Home Address 1
*
Address 2
Address 3
City/Town
*
County
Postcode
*
Reason for Cancellation
Unable to attend for personal reason
Staff - Required on ward (Clinical Duties)
Booked in error
Sickness
Facilitator Cancellation
Other
DNA/No Reason (£50.00)
*
I accept the
Terms and Conditions
and
Privacy Policy
of Participant UK Ltd.
(Participant UK Ltd provide the booking and payment platform to this organisation).
*
Terms and Conditions
No booking is confirmed until written confirmation is received from the PGME department. For full Terms and Conditions please see below. By completing you booking you are confirming you have fully read the terms and conditions.
Terms and Conditions
Dates and Times
Start Date:
23/05/2019 11:00 AM
End Date:
23/05/2029 12:00 PM
Register by:
23/05/2029 11:00 AM
Add to calendar
Location
n/a
Contact Details
Marissa Willock
marissa.willock@gosh.nhs.uk
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