Conference April 2018

To book the conference please complete form below:

Conference Days*

Title*

First Name*

Last Name*

Country*

Job Title*

Phone No*

Mobile No

Email*

Profession*

Organisation*

Organisation Type (If applicable)

Dietary Requirements (If applicable)

I wish to receive information about further conferences that may be of interest:
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Payment Method:

To facilitate identification when paying by electronic fund transfer please include your name and “Education” as a payment reference and inform us when completed. NB, if payment has not been received 10 days before the conference start date your place at the conference will not be held and will be offered to another candidate.

Bank Details:

Bank Address: Bank of Ireland, 125, O’Connell Street, Limerick.

Account Name: Milford Hospice

Account Number: 55652276.

Sort Code: 90-43-09.

IBAN: IE35 BOFI 9043 1755 6522 76

BIC: BOFIIE2D

Please specify the details of the person to be invoiced

Title*

First Name*

Last Name*

Job Title*

Organisation

Purchase order number:

Please tick to confirm that you have read understood and agree to comply with our Terms and Conditions.

Conference April 2018

To book the conference please complete form below:

Bank Details:

Please specify the details of the person to be invoiced

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