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Birthspirit's Midwifery Skills for Emergencies Intensive
- 2012 Programme - Postal Registration Form
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Please
print this form, complete it, enclose a cheque for $583.00 made out to
Birthspirit Ltd., and post to:
Birthspirit, 15 Te Awa Road,
R.D. 3, Hamilton 3283, New Zealand.
Please
book me for the following (please circle one):
Midwifery Skills for Emergencies March 7th - 9th 2012 (Wed - Fri) FULL
Midwifery Skills for Emergencies October 17th - 19th 2012 (Wed - Fri)
Midwifery Skills for Emergencies November 7th - 9th 2012 (Wed - Fri)
Midwifery Skills for Emergencies November 28th - 30th 2012 (Wed - Fri)
Accommodation needed (please circle
one) Yes /
No
Please
circle one: Employed /
Self employed
Name:
........................................................................................
Address: .........................................................................................
........................................................................................
........................................................................................
Email: .........................................................................................
Phone: ........................................................................................
Midwifery
Council Registration No. ......................................................
If
you wish to speak to someone about the Intensive please phone
Maggie Banks on 07 856 4612 or email her at maggiebanks@birthspirit.co.nz
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