Course How to pass your JAG Accreditation Visit by lhh12385


									                                                  Registration Form

How to pass your JAG Accreditation Visit
This course has been designed for Unit’s that are preparing for their JAG Accreditation Visit. It is recommended that at
least one key staff member from each Unit attends this training course. Course sizes have been limited in size, so please
indicate your order of preference to ensure that we are able to cater to everyone. Please note that a maximum of three
representatives from each Unit is allowed.

Dates and Locations (Please indicate your order of preference with a 1, 2 or 3 beside the dates below)
              23 September 2009        Royal College of Physicians, London           Note: These seminars are the last complimentary
                                                                                     How to pass your JAG Accreditation Visit seminars
              9 December 2009          Royal College of Physicians, London           that JAG will be hosting. All future seminars held
                                                                                     will be at a cost to the Unit.
              10 March 2010            Royal College of Physicians, London

Attendee Contact Details (Please complete in BLOCK letters, or electronically)

   First name                                                             Surname






   Email                                                                  Mobile

   Dietary needs

Registration Confirmation
You will receive a confirmation of your registration from the JAG Central Office. If you have not received a confirmation
within 7 working days of the course, please contact Amber Westbury on 0207 935 1174, extension 485.

How to register
By email                                                              By post
To register by email, please either complete this form                Please mail completed registration forms to
electronically and send via email or, complete the form               JAG Central Office
by hand, scan and email.                                              Att: Amber Westbury
By fax                                                                5 St Andrews Place
                                                                      Regent’s Park
Please fax any registration forms with a cover letter to
                                                                      LONDON NW1 4LB
the attention of Amber Westbury to 0207 486 4160.

Cancellation Policy
Any late cancellations or no shows will incur a cancellation fee of £50.00. You may send a colleague in your place,
however please ensure that the JAG is advised of this so that the appropriate records may be updated.

                          For further information please contact JAG Central Office
                  0207 935 1174 ext. 485 

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