Booking/Registration Form National Nursing and Midwifery Leadership and Innovation Summit: People Purpose Passion National Leadership and Innovation Centre, Office of the Nursing and Midwifery Services HSE 12th May 2015 Printworks Room, Dublin Castle, Dublin, Ireland Summit Registration
Details
Name Title (Mr, Ms, Dr, etc) Grade Department
Organisation
Telephone Email address Special Dietary Requirements
Please return completed registration forms by May 1st 2015. Booking will not be completed unless all information is supplied as requested below. Delegates will receive e-mail confirmation of summit place only. •
via e-mail: enclosing completed ‘word version’ or ‘scanned format’ registration form and/or ‘full registration details’ on e-mail to mary.sexton@hse.ie
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via post: hard copy to postal address:
Summit Registration - National Leadership and Innovation Centre Office for the Nursing and Midwifery Services
C/O Nursing & Midwifery Planning & Development Unit, HSE South Administration Building, St Marys Health Campus, Gurranabraher, Cork Please contact 021-49 21203 for registration queries only or 061 483301 for general summit queries.