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POSTGRADUATE ORTHOPAEDICS APPLICATION FORM NEWCASTLE …postgraduateorthopaedics.com/wp-content/uploads/2014/07/... · The Postgraduate Orthopaedics ethos is to try and keep costs

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Page 1: POSTGRADUATE ORTHOPAEDICS APPLICATION FORM NEWCASTLE …postgraduateorthopaedics.com/wp-content/uploads/2014/07/... · The Postgraduate Orthopaedics ethos is to try and keep costs

Postgraduate  Orthopaedics    Room  443.  Faculty  of  Life  Sciences  Northumberland  Building    Northumbria  University    Northumberland  Road                                                                                 Mob:  07540388840  Newcastle  upon  Tyne  NE1  8ST     Email:    [email protected]  

www.postgraduateorthopaedics.com    

POSTGRADUATE  ORTHOPAEDICS  

FRCS  (Tr&Orth)  Revision  Course  16  –  21st  January  2017  Lecture & Viva section Sutherland Building, Northumbria University, Newcastle upon Tyne Clinical section North East Surgery Centre, Queen Elizabeth Hospital (QEH), Gateshead

The Postgraduate Orthopaedics ethos is to try and keep costs reasonably priced for candidates. We are not running the course to satisfy a financial motive and we are essentially a not for profits organization. We want to develop the book series further for orthopaedic trainees. We have used any small profit from previous course fees to fund more professional illustrations for the Postgraduate Orthopaedics book series, support the website accompanying the book, sponsor BOTA trainee fellowships and lastly our charity work in the Middle East.

APPLICATION  FORM  (Please  complete  to  register  for  the  course)  

TITLE:    

NAME:    

SURNAME:    

HOME  ADDRESS:    

CONTACT  NUMBER:    

EMAIL  ADDRESS:    

GRADE:    

HOSPITAL  ADDRESS:    

CONTACT  NUMBER  (hospital):    

CONFIRMED  DATE  OF  PART  2  EXAM  (if  known):  

 

TRAINING  ROTATION:  

 

 

SPR  GRADE/YEAR:    

Page 2: POSTGRADUATE ORTHOPAEDICS APPLICATION FORM NEWCASTLE …postgraduateorthopaedics.com/wp-content/uploads/2014/07/... · The Postgraduate Orthopaedics ethos is to try and keep costs

Postgraduate  Orthopaedics    Room  443.  Faculty  of  Life  Sciences  Northumberland  Building    Northumbria  University    Northumberland  Road                                                                                 Mob:  07540388840  Newcastle  upon  Tyne  NE1  8ST     Email:    [email protected]  

www.postgraduateorthopaedics.com    

VIVA/CLINICAL  GROUP   In  order  to  place  you  with  comparable  candidates  in  the  viva  and  clinical  section  please  grade  yourself  on  a  scale  of  1-­‐10.One  being  little  knowledge  10  being  superb  gold  medal  standard)  

 

BOTA  registration  number    

 PLEASE  NOTE:    The  course  can  be  block  booked  but  the  Viva  and  Clinical  numbers  will  be  limited.  

Preference  will  be  given  to  candidates  attending  the  whole  6  days.  

BOTA  members  will  receive  a  £100  discount  for  the  lectures,  £100  discount  for  the  Viva  and  Clinical  day  and  a  £200  discount  for  the  whole  6-­‐day  course.  

COURSE  OPTIONS  AND  PRICE  LIST  

(Please  mark  clearly  in  the  box  which  course  you  would  like  to  attend)  

COURSE   PRICE   DEPOSIT   ! BOTA

Member

!

Full  6  day  course  (lecture  presentation  +viva  day  +clinical  day):  

£1295.00   £150.00*     £995    

Lecture  presentations  only  (day  1-­‐4):   £600.00   £100.00*     £500    

COURSE  OPTIONS  AND  PRICE  LIST  

(Please  send  a  cheque  or  bank  draft  in  £  sterling  drawn  on  a  UK  bank  payable  to  ‘Postgraduate  Orthopaedics’  along  with  your  application  form,  and  a  copy  of  your  CV  to  the  address  at  the  bottom  of  the  page.  

*The  non-­‐refundable  deposit  is  due  with  your  application  and  makes  up  part  of  your  total  fees.      Cheques  made  payable  to  Postgraduate  Orthopaedics.  BACS:  Barclays.    Account  Number:  13962164.    Sort  Code:  20-­‐59-­‐61  International:    IBAN:  GB98  BARC  2059  6113.    SWIFT:  BARCGB22    CANCELLATION  POLICY  You  have  30  days  upon  receipt  of  payment  in  which  you  can  cancel  your  application  and  receive  a  full  refund.  

The  balance  is  due  by  1  Oct  2016.  (If  you  apply  now,  you  will  still  receive  a  full  refund  if  you  cancel  within  30  days,  in  line  with  our  Cancellation  Policy).  Before  the  FINAL  PAYMENT  DATE  for  each  Course  you  can  cancel  your  booking  and  receive  a  full  refund  minus  your  deposit  (handling  fee).  

 After  the  FINAL  PAYMENT  DATE  no  refunds  will  be  made  except  within  the  30-­‐day  cancellation  period.  

 We  advise  you  to  take  out  cancellation  insurance  to  cover  you  in  case  you  are  unable  to  attend  your  Course