Irish Association of Directors of Nursing & Midwifery Conference
October 4th and 5th 2018
The Clayton Hotel Silver Springs, Tivoli, Cork
Registration Form

Connecting beyond Boundaries - Is Integration a Mere Fantasy

Delegate Registration
All attendees must register in advance of the Conference.

Registered delegates will receive the following:

Delegate pack including the programme book and other associated materials
Lunch and refreshment breaks on the days attended
Admission to the President's Dinner on Thursday 4th October

Conference Fee: €250

Venue: Clayton Hotel Silver Springs

Accomodation: Conference rates apply - tel:+353214507533 or book online at https://www.claytonhotelsilversprings.com/click-on-clayton/

Conference Enquiries: Please contact Audrey Lewis, Executive Support
Children’s Hospital Group, Block A Herberton, James’s Walk, Rialto, Dublin 8

Tel: 07669 59196 Email: audrey.lewis@nchg.ie

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* 1. Surname

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* 2. First Name

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* 3. Job Title

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* 4. At what email address would you like to be contacted?
Please ensure that you enter the correct email address

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* 5. What is your mobile phone number?

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* 6. Name and address of your organisation

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* 7. Are you a member of IADNAM?

Yes

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* 8. Do you have any special dietary requirements?

Vegetarian

Diabetic

Gluten Free

I have no special dietary requirements

Other (please specify)

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* 9.
Conference Fee €250 - Please select preferred payment option

Electronic Transfer

Please use code CONF 2018 and DO NOT FORGET TO INCLUDE your name

Bank Name: Allied Irish Bank

Bank Address: 7/12 Dame Street, Dublin 2

Sort code: 93-20-86

Account Number: 87189-081

BIC code: AIBKIE2DXXX

IBAN: IE16AIBK93208687189081

Cheque

Please make payable to IADNAM and post to Karen Greene, Director of Nursing , Beaumont Hospital, Dublin

Sponsorship

Details for invoicing will be required

Question Title

* 1. Surname

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* 2. First Name

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* 3. Job Title

Question Title

* 4. At what email address would you like to be contacted?Please ensure that you enter the correct email address

Question Title

* 5. What is your mobile phone number?

Question Title

* 6. Name and address of your organisation

Question Title

* 7. Are you a member of IADNAM?

Question Title

* 8. Do you have any special dietary requirements?

Question Title

* 9. Conference Fee €250 - Please select preferred payment option

* 4. At what email address would you like to be contacted?
Please ensure that you enter the correct email address

* 9.
Conference Fee €250 - Please select preferred payment option