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Medilink Innovation Day and Healthcare Business Awards 2010 (+ YHIN Launch) - Event Registration

 

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1. Title

Title

*

2. Firstname

Firstname

*

3. Surname

Surname

*

4. Job title / position

Job title / position

*

5. Name of organisation

Name of organisation

*

6. Address line 1

Address line 1

7. Address line 2

Address line 2

8. Address line 3

Address line 3

9. Address line 4

Address line 4

*

10. Town / City

Town / City

*

11. Postcode

Postcode

*

12. Email - used for REGISTRATION CONFIRMATION

Email - used for REGISTRATION CONFIRMATION

*

13. Contact telephone

Contact telephone

14. If you are a member of Medilink (Yorkshire & Humber) Ltd will you be attending the AGM, which starts 30 minutes before the Innovation Day?

If you are a member of Medilink (Yorkshire & Humber) Ltd will you be attending the AGM, which starts 30 minutes before the Innovation Day?   Yes

No

15. Any special dietary requirements ie. vegetarian

Any special dietary requirements ie. vegetarian

16. Wheelchair access needed?

Wheelchair access needed?   No Yes

*

17. How did you hear about this event?

How did you hear about this event?   Medilink Y&H (Web Portal / e-Update) Yorkshire Health Innovation Network Flyer Business Link Medipex Yorkshire Forward Health Tech & Medicines KTN Colleague Other

If other, please specify