Advancing the Multidisciplinary Treatment of Colorectal Liver Metastases registration form

We are pleased to invite you to The Royal Marsden for an educational meeting on the treatment of colorectal liver metastases.

This event is free to attend but you must register in advance. You can register online using this form or you can download, print and post this version of the form (PDF).

Your details

Title *

First name *

Last name *

Job title *

Organisation *

Email *

Confirm email *

Address line 1 *

Address line 2

Town / city *

County

Postcode *

Is this your... Home address
Work address

Telephone

General

Where did you hear about this event? * Direct mailing
Royal Marsden website
Other website
Email
Colleague or friend
Journal / magazine
Other (please specify)

Applicant’s Declaration

Data Protection Act 1998: I agree to The Royal Marsden NHS Foundation Trust processing personal data contained on this form, or other data which may be obtained from me or other people or organisations whilst I am applying for this event. I agree to the processing of such data for any purpose connected with my attendance at this Royal Marsden event, or my health and safety whilst on Royal Marsden premises or for any other legitimate purpose.

Please tick if you do not agree to your email address being used to advise you of forthcoming events which may be of interest

Registration form