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Booking Form

Please note that this form is in development. To book a place on a course, please contact Kate Cook at Yeovil Academy by e-mail or phone 01935 384579

To fjcarter@mail.com


Name:
Position::
Organisation:
Address:

Country
Tel (day):
Fax no:
Invoice address (if different from above):

Country
Gender	Male Female

Please enter your email address:

If you wish to attend the Enhanced Recovery in Practice Seminar, please choose a date from the drop down list:

If you wish to attend the Laparoscopic Colorectal Surgery for Theatre Practitioners, please choose a date from the drop down list:

If you wish to attend any other courses, please select them below:

Laparoscopic colorectal course: date to be arranged 2008

Laparoscopic ultrasound for cholecystectomy course: 9th April 2008

Credit card details can be telephoned into the Yeovil Academy +44 1935 384649 or

e-mailed to Kate Cook. Kate.Cook@ydh.nhs.uk

ON LINE BOOKING CONDITIONS:

Please read our booking conditions and check the box below to confirm that you agree to these conditions:

I agree to the booking conditions

General Information:

If you have any special dietary requirements, please describe them in the space below:

If you have any other queries, please list them in the space below: