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Abstract: . . . With accommodation contact course organiser ß Day only (no accommodation) £650 ß Special dietary requirements (Please state)________________________ Please send completed form or fax to the appropriate course organizer. . . . . . . GENERAL HOSPITAL Level F Centre Block Tremona Rd Mail point 113 Southampton SO16 6YD Tel (44) 023 8079 6317 Fax (44) 023 8079 4945 email: jmt1@soton.ac.uk Page 6 REGISTRATION FORM The Intercollegiate Course on Human Nutrition Please complete and return this form as soon as possible and in any case at least one calendar month prior to your course. Surname __________________________________________________________ . . . . . . accommodation contact course organiser ß Day only (no accommodation) £650 ß Special dietary requirements (Please state)________________________ Please send completed form or fax to the appropriate course organizer. . . . . . . Centre Block Tremona Rd Mail point 113 Southampton SO16 6YD Tel (44) 023 8079 6317 Fax (44) 023 8079 4945 email: jmt1@soton.ac.uk Page 6 REGISTRATION FORM The Intercollegiate Course on Human Nutrition Please complete and return this form as soon as possible and in any case at least one calendar month prior to your course. Surname __________________________________________________________ . . . . . . Trust/Other _______________________________ Address ___________________________________________________________ ___________________________________________________________________ Training in Nutrition ___________________________________________________ How did you hear about the course? ______________________________________ I would like to attend the following course (tick . . . . . . Manor, Southampton Course, 7-11 March 2005 ß With accommodation contact course organiser ß Day only (no accommodation) £650 ß Nottingham Strathdon Hotel, Nottingham Course, 5-9 September 2005 ß With accommodation contact course organiser ß Day only (no accommodation) £650 ß Special dietary requirements (Please state)________________________ Please send completed form or . . . --2215,6,185,2402,11075
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