1. Personal Details
Title
Gender
Forename
Surname
Address
Telephone (home) (optional)
Telephone (mobile)
Email 1
Email 2
All future correspondence regarding the course will be sent via email. Hence please ensure that you provide the one(s) you check regularly.
2. Professional Details
General Practice       Hospital
Registration fee and deposit:

The event is free to attend, but a refundable deposit is required to reserve your place. The deposit will be returned along with the certificate on the day. Failure to attend the event will result in the deposit being forfeited. Please make cheques payable to 'BIDA' and send it to the address below.

£15 for Members and Junior Doctors
£25 for Non-Members


Registration:

Following online registration using the link below,  the deposit in the form of a cheque drawn in favour of 'BIDA' should be send to:

Alison
Central Office Manager,
BIDA 316A Buxton Road,
Great Moor,
Stockport,
SK2 7DD
.

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