Booking Form

Title:
First Name:
Surname:
Job Title:
Company:
Address:



Daytime Telephone:
Email Address:
Other Needs (e.g.
Diet,accommodation?):

Payment:
Please invoice me: My purchase No./Reference is:
I will send a cheque for the full amount, payable to 'Pharmacodes Medical Communications Ltd.'. A VAT receipt will be issued on receipt of payment.

Terms & Conditions:
In the event of unforeseen circumstances, Pharmacodes Medical Communications Ltd. reserves the right to cancel or alter the content or speakers without notice. Cancellations made by the delegate 30 days before the event and confirmed in writing will receive a full refund less £75 administration fee. After this date fees will not be refunded. Substitutions may be made at any time without charge.

Confirm Your Booking:
Please confirm my registration for the above course. I agree to the terms and conditions
Please keep me informed on future courses, services and offers.