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1. Your Details
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Title
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Gender
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Forename
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E.g., Anthony Mathew Jones (first name in
red)
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Enter any middle name(s)
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E.g., Anthony Mathew Jones (middle name in
red)
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Surname
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E.g., Anthony Mathew Jones (last name in
red)
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Please ensure to enter your names accurately since it will be printed in name badges
and certificates
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Address
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Country
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Pin code/Post code/ Zip code
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Landline Number
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Telephone (mobile)
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Email 1
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Email 2
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Twitter ID
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All future correspondence regarding the course will be sent via email. Hence please
ensure that you provide the one(s) you check regularly.
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2.Your Professional Status
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Please select your option
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Hospital
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Select your hospital
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Your registration is not complete and your place in course will not be confirmed until all fields are completed.
Please email us at contact@doctorsacademy.org.uk
if you experience any difficulties during the registration or payment process. One
of our support staff will get in touch with you immediately. Thank you
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