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The RCGP Sex, Drugs & HIV Task Group The Introductory Certificate in Sexual Health (ICSH) Monday 27 th September 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 30 th July 2010 Cheques should be made payable to the RCGP Cheques should be sent c/o 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 p £170 for College members : £190 for other candidates

RCGP membership number:


http://www.rcgp.org.uk/docs/smu_ICSH%20Booking%20form%2027-09-10