Registration form
Name
Job title
Place of work
Contact address
Daytime contact number
Email
Special dietary requirements
Already attended a simulation course?
Yes
No
If yes, name and date if possible:
Please select the course to attend:
EASE 1
EASE 2
Please select a date to attend:
Places available in brackets
EASE 2 Thur. 23rd Sept 2010 (6)
EASE 2 Thur. 14th October 2010 (1)
EASE 2 Thur. 20th Jan 2011 (7)
EASE 2 Thur. 24th Mar 2011 (7)
EASE 1 Thur. 21st Apr 2011 (8)
EASE 1 Thur. 19th May 2011 (8)