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					                   Plastic Surgery Taster Day 21st May 2011
                    St George’s Medical School, Tooting, London

                                     Registration 8:30

    In order to reserve a place please fill in this booking form and return it with a cheque
       to the address below; places will be allocated on a first come, first served basis.


Please enclose a £15/£20 cheque, depending on membership status, made payable to ‘SGUL’

  Once your form has been received a confirmation email will be sent securing your place.

 Please be advised that if you do not receive and email you are not booked onto the course.


                Full information is available at opsinsurgery.com/plasticsday

                      Please email enquiries to m0901988@sgul.ac.uk


               Full Name
            Medical School
           Course and year
       Correspondence address




                  Email
            Phone number



                                  Please return this form to:
Flat 66 Bassett House, 1 Durnsford Road, Wimbledon,
                  London, SW19 8EA

				
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