Department of Obstetrics & Gynaecology
12th Annual Paul Harding Research Awards Day

May 14, 2014

This event is an Accredited Group Learning Activity (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada, and approved by Continuing Professional Development, Schulich School of Medicine & Dentistry, Western University (6.75 hours). Note: Each participant should claim only those hours of credit that he/she actually spent participating in the educational program.

(NOTE THAT IN THE FORM BELOW AN ASTERISK INDICATES A REQUIRED FIELD)

Name*
Email*
   
 
 


 


   
My Dinner Choice:


   
Guest Name:
My Guest's Dinner Choice:

Roasted Tofu


   
Dietary Restrictions:
(Please indicate whether this refers to yourself or your guest)

Please note that the Department will be required to provide Windermere Manor with the number of confirmed dinner attendees the week before the event. If you register for the dinner, and your plans change in the interim, please make sure you let us know no later than Thursday, May 8 that you will not be able to attend.

If you fail to do so, you will be billed for your meal (and that of your guest as well if applicable).