HANDHELD ECHOCARDIOGRAPHY FOR CRITICAL CARE

Please email: info@handheldcourses.co.uk to confirm a place and then complete the registration form and return with payment to: Handheld Courses, 21 Syon Park Gardens, Isleworth, Middlesex, TW7 5NE. Alternatively please fax the completed registration form to: 020 8181 7183 .
PLEASE DO NOT ATTACH THIS FORM TO AN EMAIL

Register For:

7-8 Jul 08

10-11 Nov 08

Payment:

Please invoice my employer for the course fee

I enclose a cheque for £587.50 (incl VAT) made payable to CARDIAC REPORT LTD

Title:

Surname:

First Name:

Address:

Postcode:

Invoice Name and address:

Postcode:

Daytime Tel No:

Evening Tel No:

Email:

Current Position:

Speciality

Hospital of Work:

Where did you hear about the course?

Dietary Needs:

For further information please email Kirsty McGuire at info@handheldcourses.co.uk or call 07986 284 722

Handheld Courses, 21 Syon Park Gardens, Isleworth, Middlesex, TW7 5NE