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NWIATH ROOM BOOKING
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Email
*
Your email
Name of person completing this request
Your answer
Name of Teaching Lead
*
Your answer
Tutor email address
*
Your answer
Contact Number
Your answer
VENUE
*
ALDER HEY
EAST LANCS
EDGE HILL
THE CHRISTIE
Required
DATE
*
MM
/
DD
/
YYYY
Start time
*
Time
:
AM
PM
Finish Time
Time
:
AM
PM
TITLE OF SESSION
*
Your answer
How many attendees?
Your answer
If this is a recurrent booking please state how often (for example every Monday, or 1st Monday of every month)
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Who is the teaching for?
*
Radiology ST1's
Radiology ST2's +
Reporting Radiographers
Multi-Professionals
Others
Required
If "Others" please give details
Your answer
Please indicate whether this teaching session is for staff and students from the
*
Trust
Hospitals from the local ICS
Hospitals across the North West Region
Other:
Required
Will you be streaming to other sites?
*
Yes
No
Do you require a Flyer/Certificates of Attendance for your course
*
Yes
No
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