2018 October Registration Form

Page 1

Spirometry Training Course Registration Form ❑

YES! I would like to attend the Spirometry Training Course.

Please book me in for the course on 23 and 24 October 2018, Hamilton COST: $580 per participant excl GST TIME: 9am – 4pm both days Lunch and light snacks provided Venue: Juke Box Diner Conference Room (upstairs), 11 Railside Place, Dinsdale Hamilton. MY DETAILS Name: Company/ Organisation: Position:

Address:

Phone:

Mobile:

Email for participant: Email and person to send invoice to: Dietary Requirements: Does your organisation have its own spirometer?

Thank you for registering – please email this form to: sheryl.long@asthmawaikato.org.nz

Asthma & Respiratory Services (Waikato) Inc 67 Claude St, Fairfield, Hamilton 3214 | PO Box 7013, Hamilton East, Hamilton 3247 P 07 838 0851 | info@asthmawaikato.org.nz

asthmawaikato.org.nz facebook.com/asthma.waikato


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