IMPACT
COURSE
Venue: Suttie Centre, Foresterhill, Aberdeen
A P P L I C A T I O N
F O R M
*
Title:
*
Surname:
*
Forename:
(Known As):
*
GMC/NMC Pin number:
*
Address for Correspondence:
*
Email address:
*
Daytime Telephone No:
*
Present Post & Grade:
*
Specialty:
*
Hospital:
Please select preferred date of course:
21 - 22 May 2012
Waiting List
*Are required fields
You will receive an email in due course with further details and to confirm your place on the course should your application be accepted.
All Correspondence to:
Jerry Morse, Clinical Skills Manager
Clinical Skills Centre
The Suttie Centre for Teaching and Learning in Healthcare
Foresterhill
Aberdeen
AB25 2ZD
Telephone:
01224 437733
Email:
jerry.morse@abdn.ac.uk
