Applicationformentnursesmasterclass 6th2012 updated 1 post 1 v1 by j720e0

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									                    APPLICATION                                FORM
                        ENT MASTER CLASS®
         6th NATIONAL ENT NURSING MASTER CLASS

                      30TH SEPTEMBER 2012
          Post graduate Centre, Doncaster Royal Infirmary

Name:__________________________________________________________________

Address: _______________________________________________________________

Current Post: ___________________________________________________________

E-mail Address: _________________________________________________________

Contact telephone number: ------------------------------------------------------------------------

Signature: ____________________________________

Date:_________________________________________

Dietary Requirements:____________________________________________________




     Please enclose a cheque of £20/- Dated 30/9/12, to hold your place on the master
      class. This will be returned if you attend on the day.
     Please do not email your application forms or CV. Please kindly post
      altogether.
     Cheques to be made to: ENT Masterclass
     Incomplete or inaccurate forms or cheques will incur an admin charge of £20/-
     Please send application forms to: MS Kirsty Clarke,
                                         Acting Matron Special Surgery
                                         Doncaster Royal Infirmary,
                                         Armthorpe Road,
                                         Doncaster,
                                         DN2 5LT
     E- Mail: kirsty.clarke@dbh.nhs.uk

								
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