DELEGATE INFORMATION NAME JOB TITLE COMPANY COMPANY ADDRESS POST CODE CONTACT NUMBER EMAIL Training Events and Dates (please tick the box of the event/s you wish to register for): Drug Safety Module 20 th – 21 st February 2015 Clinical Pharmacology and Therapeutics Module 20 th – 21 st March 2015 Medicines Regulation Module 24 th – 25 th April 2015 Statistics and Data Management Module 29 th – 30 th May 2015 Critical Appraisal Skills Workshop 31 st May 2015 Clinical Development and Discovery Medicine Module 26 th – 27 th June 2015 Healthcare Marketplace Module 24 th – 25 th July 2015 MCQ Exam Technique & Mock Exam Module 5 th September 2015* SAQ/Critical Appraisal Exam Technique 10 th –11 th October 2015* & Mock Exam Module Venue: The Bull Hotel, Oxford Road, Gerrards Cross, Buckinghamshire SL9 7PA Event Fees: £1,350 per two-day module; £696 per one-day module. A 2.5% surcharge will be applied if paying by credit/debit card. All event fees include course materials, lunch, refreshments and VAT. Discounts may be available for advance block bookings. Please note that event fees do not include accommodation. BaxterBoyd Limited is a private limited company registered in England and Wales, Registered Number: 7068297 Registered Office: 1 Park Street, Macclesfield SK11 6SR, United Kingdom Diploma in Pharmaceutical Medicine Training Programme 2015 Registration BaxterBo DPM 2015 *TBC once exam dates are
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DELEGATE INFORMATIONNAME
JOB TITLE
COMPANY
COMPANYADDRESS
POST CODE
CONTACT NUMBER
EMAIL
Training Events and Dates (please tick the box of the event/s you wish to register for):
Drug Safety Module 20th – 21st February 2015 Clinical Pharmacology and Therapeutics Module 20th – 21st March 2015 Medicines Regulation Module 24th – 25th April 2015 Statistics and Data Management Module 29th – 30th May 2015 Critical Appraisal Skills Workshop 31st May 2015 Clinical Development and Discovery Medicine Module 26th – 27th June 2015 Healthcare Marketplace Module 24th – 25th July 2015 MCQ Exam Technique & Mock Exam Module 5th September 2015* SAQ/Critical Appraisal Exam Technique 10th–11th October 2015*
Event Fees: £1,350 per two-day module; £696 per one-day module. A 2.5% surcharge will be applied if paying by credit/debit card. All event fees include course materials, lunch, refreshments and VAT. Discounts may be available for advance block bookings. Please note that event fees do not include accommodation.
Bookings & Further Information: To reserve a place at any of these training events please complete the registration form giving full payment details and email to [email protected] or send it for the attention of Mel Entwisle, BaxterBoyd, Electra House, Crewe Business Park, Crewe, CW1 6GL. For further information, please contact BaxterBoyd on +44 (0)1270 270010, or alternatively visit the BaxterBoyd website at www.baxterboyd.com.
Payment: Pre-payment is required for all registrations. Upon receipt of the registration form and payment by cheque, BACS or credit card, delegates will be sent a registration confirmation and an appropriate receipt for their records. Registration will be possible on the day of the event at the door subject to availability, which cannot be guaranteed
[Type text]BaxterBoyd Limited is a private limited company registered in England and Wales, Registered Number: 7068297
Registered Office: 1 Park Street, Macclesfield SK11 6SR, United Kingdom
Diploma in Pharmaceutical Medicine Training Programme 2015 Registration Form
except for advanced registrations. For those registering at the event, payment will be required on the day by cheque or credit card.
Please make cheques payable to BaxterBoyd Limited
Credit/debit card payments (Please note that a 2.5% surcharge will be applied for payments made by credit/debit card. We do not accept payments via AMEX):
Santander Business Banking, Bridle Road, Bootle, Merseyside LR30 4GB
Sort Code: 09–01–53
Account Number: 22262984
IBAN: GB13ABBY09015322262984
Accommodation: Preferential corporate rates have been negotiated for delegates wishing to stay at The Bull Hotel (subject to room availability). Reservations can be made by contacting The Bull Hotel on +44 (0) 1753 885995 quoting ‘BaxterBoyd’.
Cancellations: Should you be unable to attend for any reason, a substitute delegate from the same company or organisation is welcome to attend in your place at no extra charge. A registration may be transferred to a delegate from the same company or organisation at anytime. If this is not possible, for cancellations received in writing at least 28 days prior to the start of the module an administrative charge of £100.00 (+ VAT) will be made and the remaining fees refunded. BaxterBoyd regrets that no refunds will be given for cancellations made within 28 days of the module start date although full course documentation will, however, be sent to the delegate.
BaxterBoyd reserves the right to vary the programme of its training events without notice. In the unlikely event that a training event has to be cancelled for any reason, BaxterBoyd are not liable for any costs incurred by delegates in connection with their attendance. However, in this eventuality all paid registrations will be refunded in full.
Data Protection: The personal information shown above, or provided by you, will be held on a database and will not be shared with any other companies. This information may be used to keep you up-to-date with developments in your industry. If you do not want your details to be used for this purpose, please notify us in writing and email to [email protected].
[Type text]BaxterBoyd Limited is a private limited company registered in England and Wales, Registered Number: 7068297
Registered Office: 1 Park Street, Macclesfield SK11 6SR, United Kingdom
Diploma in Pharmaceutical Medicine Training Programme 2015 Registration
