This form is in three parts. Please complete the form as follows:

Part 1 – Organisation and delegate details

In this part you need to give details about your organisation and the delegate you want to register.

Part 2 – Registration for the ELF patient organisation networking day

Please choose which workshop you would like to attend. NB: As the workshops are on at the same time you can only attend one. 

Part 3 – Bursaries

Please fill in this part if you would like to apply for a €300 bursary.

Please read the information in each section carefully and complete all sections that apply to you. The deadline for the completion of this registration is 30 May, 2016.