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Date: Thursday, 2 December 2010 - Friday, 3 December 2010

The Queen Mother Conference Centre
Royal College of Physicians of Edinburgh
9 Queen Street
Edinburgh EH2 1JQ

Basic information

Title: *
Forename: *
Surname: *
Post-Nominal:
E-mail address: *
Telephone: *
Mobile:

Address details

Address line 1: *
Address line 2:
Town / City: *
Postcode / Zip Code: *
Country *

Further Details

Current Post (or if none/retired please state): *

Workplace:
Specialty:
Dietary Requirements:

If you selected 'other' for dietary requirements, please specify in the box below.

Online registration for this event closes on 30 November 2010 but places may still be available after that date - please contact the Education Co-ordinator.

If you wish to register as Unpaid Post - if confirmation of status provided - please contact the Education Co-ordinator at RCPE.

Collegiate Members and Associates of the RCPE in clinical research posts may be eligible for funding - please contact the Education Co-ordinator for further information.

Attendance under the RCPE's "block grant" scheme applies only to trainees in the medical specialties in East of Scotland, North of Scotland or South East Scotland Deaneries. Please ensure that you notify your Deanery that you wish to access the scheme before registering.

Eileen Strawn
Symposium Co-ordinator
Email: e.strawn@rcpe.ac.uk

Your cost so far: £0.00

Please select applicable fee category (fees shown are per day)* Full Fee (£120)
RCPE Fellow (£60)
RCPE Collegiate Member/Associate (£60)
RCPE e-Associate (£60)
Nurse/AHP/Pharmacist (£45)
Retired FRCPE - lunch (£15)
Retired FRCPE - no lunch
Medical or other healthcare student
Block Grant attendee

If attending under the Block Grant Scheme, please select your Deanery

I will attend on* Thursday 2nd December
Friday 3rd December
Both days (2nd & 3rd)

Attend 50th St Andrewstide Festival Dinner* Yes (£48)
No

I wish to bring a guest* Yes (£48)
No

Name of guest and any dietary requirements

The total cost is: £

Please select your preferred payment method: Pay using the secure online payment gateway.
Request an invoice.

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Organisation/Department:
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Please Note

PLEASE NOTE: If you have to cancel your place within seven days of this symposium, we regret that we are unable to provide a refund. However, substitute participants will be accepted at the discretion of the organisers.

INVOICES: We can only issue invoices to employers or other organisations. Please do not ask us to invoice you or another individual for this purpose.