Liverpool Hospital

DSTC Courses Registration

Note: * indicates required fields
If the course you are interested in is fully subscribed and you would like to be added to the waitlist, please click this link: DSTC Course Waitlist Form

Course Details

*Name:

Date:

Location:

Attendee Details

*Title:

*First Name:

*Last Name:

*Position:
(SET Year at the time of course dates if Applicable)

*Hospital:

*Department:

*Phone:

*Email Address:

Confirm Email Address:

RACS ID (if applicable):

*Scrub Size:

*Gown Size:

*Glove Size:

Dietary Requirements:

Billing Details

*Address Line 1:

Address Line 2:

*Suburb:

*Post Code:

*State:

*Country:

I understand that the course requirements for completion include participation in all three days of lectures, simulations, and labs including cadavers and/or live tissue.

On the following form, for the application date, enter todays date, reference should be DSTC Course, payment amount will be the total amount payable.

Registration Enquiries:

swslhd-dstc@health.nsw.gov.au or Phone: +61 2 8738 6489