Welcome to the Faculty of Sports and Exercise Medicine

Individual Registration

Please enter information in the form below to process registration for event Virtual Spring Study Day 2021 - Ulster University.

Salutation *

First Name *

Last Name *

Email *

Payment Options *

Fellows & Members - €30.00

Non Fellows & Members - €35.00

Irish Medical Council Number if applicable

Profession (GP/Consultant/Nurse/Allied Healthcare Professional/Other)

Your location (hospital or county)

Please tick the box option if you are happy for me to send on you details to Medcafe (our webinar IT provider). Your details will need to be sent to Medcafe in order to view recording of webinar.

Yes

Payment Information

Amount

€

Payment Method

RCSI Credit Card Payments

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Expiration Date*

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