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    Birmingham Ocular Trauma Course 2011 REGISTRATION DETAILS Personal Information Title Surname Forenames Job title Work address Daytime phone Home address Evening phone Mobile phone E-mail address please send completed form with correct payment made payable to: ophthalmic teaching courses.

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    Birmingham Ocular Trauma Course 2011 REGISTRATION DETAILS Personal Information Title Surname Forenames Job title Work address Daytime phone Home address Evening phone Mobile phone E-mail address please send completed form with correct payment made payable to: ophthalmic teaching courses.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
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    400 views1 page

    BOTC Registration Form

    Uploaded by

    ash_suja
    Birmingham Ocular Trauma Course 2011 REGISTRATION DETAILS Personal Information Title Surname Forenames Job title Work address Daytime phone Home address Evening phone Mobile phone E-mail address please send completed form with correct payment made payable to: ophthalmic teaching courses.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Birmingham Ocular Trauma Course 2011

    REGISTRATION DETAILS
    Personal Information
    Title Surname Forenames Job title Work address Daytime phone Home address Evening phone Mobile phone E-mail address Please send completed form with correct payment made payable to: Ophthalmic Teaching Courses 150 90 for trainees - please include letter to confirm training status from supervisor
    Send to: Parul Begum (Trauma Course) BMEC, City Hospital, Dudley Road, Birmingham B18 7QH To reserve your place: Print and fax your form to 01215076791 FAO: Parul Begum (Trauma Course) or Email to: parul.begum@nhs.net

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