Ophthalmology Caledonia

APPLICATION FORM Download here

Name………..……………………………………………

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Institution ………………………………………………..

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........……………………………………………………….

Phone ………………………

Email ……………………….

(Please ensure that your email account is active. All correspondence shall be done through email)

Any special requirements (food, disability etc) ……………………….

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Signature…………………………………………..

FEE: £ 100 before 1st July 2010; £ 120 thereafter

Please make cheques payable to :

"Ophthalmology Caledonia -FUND732346 "

Post to:

Ms Susan Campbell,

Department of Ophthalmology,

Gartnavel General Hospital,

Glasgow, G12 0YN

Email susan.campbell2@ggc.scot.nhs.uk

Phone 0141 2112934

Fax 0141 2112054