Please enter your details below:
 
..................................................................................................
Title
 First Name
 Surname
GDC Number
  Principal
Associate
Assistant
..................................................................................................
Practice Name
Practice Address
Post Code
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Practice Tel No
Mobile No
 Home No
Email Address
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Course Applied for
Course Reference No 
Course Date
Venue
  Single Application
Team
In surgery
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Cost £
Discount of applicable  £
Total Cost £
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You will be contacted by phone for your credit or debit card details.

Alternatively please telephone 0870 1258815 where payment can be taken over the telephone.

For 0%  interest free Credit  up to 12 months for workshops please phone for details

Terms and Conditions

All fees include attendance at the lecture(s) /Seminars /Workshop(s)  selected
Refreshments will be supplied/ lunch supplied on full day courses

Cancellations must be received in writing 28 days prior to the seminar. We would suggest Faxing the letter prior to posting for security

A refund of 90% of the booking rate will be made within this period. After that date, no refunds will be given under any circumstances.  Crystal Clear reserves the right to change the conference sessions or speakers in case of illness or other circumstances beyond control

Please contact directly if unsure or doubt with regards the booking process