3rd Annual Paediatric Gastroenterology Study Day
REGISTRATION FORM
Paediatric Research Society
British Association of General Paediatrics
Autumn Scientific Meeting
8th & 9th November 2010
Worsley Park Marriott Hotel
Worsley, Manchester M28 2QT
Please type or print in capital letters.
Please use one form per participant
I wish to attend the PRS Autumn Meeting 2010
Title: ………………...First name:…………………….. Surname:……………………..……..
Hospital: …………………………………………………………………………………………….
Address for Correspondence:………… ……………………………………………………………………
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Telephone No: ……………………………………………………………….
Fax No: ………………………………E mail.……………………………………………………………….
Job Title: ……………………………………………………………………………………………………….
Any Special Dietary Requi rements?……………………..………………………………………….………
MEETING FEE:
Residential
Meeting, accommodation with evening meal & refreshments
Non-residential
£165
Meeting with refreshments £ 65
Please make cheques payable to: "PRS Manchester 2010"
Please return this form and a cheque to:-
Dr Stephen Playfor
Paediatric Intensive Care Unit
Royal Manchester Children's Hospital
Oxford Road
Manchester M13 9WL
United Kingdom
Tel; 0161 701 8045
Fax; 0161 701 8098
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