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Clinical trial (GCP) Good clinical Practice co-ordination in practice training

* An invoice will be issued
* Registration will only be confirmed once proof of payment has been received.
* A registration cancellation fee of 15% will be levied on the cancellation of a confirmed registration within 7 ( seven ) working days of the course date.

E-mail Address: *
Name: *
Surname: *
Qualification by other trade (e.g. Sister, Nurse, Receptionist, extra): *
Number of months / years experience as a Study Co-ordinator : *
Last GCP Course: Year
Which company presented?
Name of Course:
Tel No: (W ) *
Cell Phone: *
Fax Number:
DETAILS OF EMPLOYER : DR. *
Work : Physical address : *
Work : Postal address : *
Tel No : *
Fax No: *
E-mail address: *
Vat Registration Number , ( if applicable ) :
Person Responsible for payment. *
Name: *
Date: *
* Required
Address: 11 Nonna Street, Birchleigh North, Kempton Park
Telephone: +27 11 391 3003 Fax: 086 652 7852
Email:
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