BritSPAG MDT CBD registration form 
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Friday 17th November 12.30-13.30pm

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Correo electrónico *
Name(as desired on certificate) *
Email Address *
My speciality is: *
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I am a: *
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Location of workplace 

If in the UK, please state town / city of work
If from outside of UK, please state country
Where did you hear about the PAG MDT from? *
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Do you wish to be added to the mailing list for further National PAG Sessions? *
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