http://www.rcgp.org.uk/docs/smu_%20ICSH%20Booking%20form%2013th%20July

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The RCGP Sex, Drugs & HIV Task Group The Introductory Certificate in Sexual Health (ICSH) Tuesday 13 th July 2010, Southwark Cathedral, London, SE1 9DA To book a place at this event please complete the attached form and return it to: e-mail:

tempsmu@rcgp.org.uk

Fax:

020 7173 6089

Address:

RCGP SMU Suite 314 Frazer House 32/38 Leman Street London E1 8EW

• • • • •

Payment is by cheque only and required no later than the 22 nd May 2010 Cheques should be made payable to the RCGP Cheques should be sent to RCGP SMU at the address above Refunds are not available unless another delegate fills your place Confirmation will be sent by email

Name

Telephone Number

E-mail Address Contact Address

Costs - please tick which è £170 for College members ¸ £190 for other candidates

RCGP membership number:


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