Registration Form

If you'd like to hold an event during National Pathology Week, please fill in the form below: Please note the drop down menu which allows you to select your region lists the Royal College of Pathologists designated regions.
Boxes with an asterisk next to them are required fields.

Title of the event *

Name of Organiser *

What is your speciality?

Name of employing Trust *

Contact email (this is purely for College use and will not appear on the website) *

Location of event (including full postal address and name of venue)

Address 1

Address 2

Town

County

Postcode

RCPath Region *

Date of event *

Start time *

End time *

Will your event be repeated on more than one day? If so, please indicate which other days during National Pathology Week your event will be taking place.

Monday 1st November
Tuesday 2nd November
Wednesday 3rd November
Thursday 4th November
Friday 5th November
Saturday 6th November
Sunday 7th November

Short description (this will be seen by the public on www.nationalpathologyweek.org) *

Full page description (this will be seen by the public on www.nationalpathologyweek.org)

Target audience (e.g. Local schools, GCSE or A Level students, healthcare professionals or medical students) *

Can members of the public attend?

Yes
No

Minimum age

Capacity (maximum number that can attend) *

Can this event be booked in advance?

Yes
No

Will refreshments be available? If so, what?

Contact details for those wishing to attend the event (these will be available to the public on www.nationalpathologyweek.org) *

Please provide us with a contact address for the organiser of this event. Any promotional items requested will be sent to this address (for College use only). *

Line 1
Line 2
Town
County
Postcode
Country

Do you require promotional material for your event?

Yes
No

Registration Form

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