5^th National Quality Improvement Conference

7^th July 2018, Postgraduate Centre, Stoke Mandeville Hospital, Aylesbury, Buckinghamshire

Register for the Conference

To ensure that confirmation of place is not delayed, could you kindly state if you are registering and paying for this course/event for yourself or on behalf of someone else?

I am registering and paying for myself

I am registering and paying on behalf of someone

Please provide the DETAILS OF THE STUDENT/DOCTOR on behalf of whom you are registering and paying:

Title

Gender

Enter your first name E.g., Anthony Mathew Jones (first name in red)

Enter your surname E.g., Anthony MathewJones (last name in red)

Address

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Landline Number

Please select whether the candidate is a doctor or medical student.

Medical Student

Doctor

Hospital

Level of Training/Experience

Please enter your level of training/experience

University

Please enter your University

Year in Medical School

Your registration is not complete and your place in course will not be confirmed until all fields are completed.

Please provide YOUR DETAILS so that we can match the payment with the candidate's details in our system.

Forename

Surname

Address

Country

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Phone number (including country code if outside the UK)

Please state your relation to this candidate

5th National Quality Improvement Conference

Register for the Conference

5^th National Quality Improvement Conference