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HOW TO REGISTER:  (note – CPD approval pending)


Please complete in BLOCK CAPITALS and send payment to meeting organisers Brian Smith Associates (BSA), Lakeside House, Quarry Lane, Chichester, West Sussex PO19 2NY. (cheques payable to BASHH)


Receipts will be sent once your application is processed and payment confirmed. Please contact BSA with any queries on Tel: 01243 539999 or e-mail: debbie@briansmithassociates.co.uk 

PLEASE COMPLETE THE FOLLOWING:

NAME: (Title, Forename, Surname): .........................................................................................

HOSPITAL/CLINIC & DEPARTMENT: .......................................................................................

CONTACT ADDRESS:..................................................................................................................

....................................................................................................... POSTCODE: ___________

DAYTIME TEL: ............................................................................

EMAIL: .........................................................................................



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