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Midwife meetup registration form
Midwife meetup registration form
Name
*
First
Last
Email
*
Enter Email
Confirm Email
Phone
*
Which organisation do you work / study with?
*
North Bristol NHS Trust
Royal United Hospitals Bath NHS Trust
United Hospitals Bristol NHS Trust
University of Bristol
University West of England
Other, please specifiy
Other, please specify
*
What is your job role?
*
Antenatal Ward Midwife
Intrapartum Midwife
Postnatal Midwife
Community Midwife
Rotational Midwife
Obstetrician
Anesthetist
Maternity Health Care Assistant
Mental Healthcare Professional
Student Midwife
Medical Student
Other, please specify
Other, please specify
*
Standard Midwife Meetup Ticket - £10
Price:
£ 10.00
Quantity:
Student Ticket - £8
This discounted ticket is for student midwives and medical students only.
Price:
£ 8.00
Quantity:
Ticket Amount
Name of additional attendee 1
*
First
Last
Name of additional attendee 2
*
First
Last
Name of additional attendee 3
*
First
Last
Name of additional attendee 4
*
First
Last
Total
£ 0.00
Credit Card
American Express
Discover
MasterCard
Visa
Card Number
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
Expiration Date
Security Code
Cardholder Name
Testimonial
We would recommend this course to anyone about to have their first baby. Not scary and up-to-date information.
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Our midwives
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