DSTC Courses Registration

Note: * indicates required fields

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, reference should be Course Fee - Trauma DSTC, payment amount will be the total cost shown above.

Please ensure all fields are completed accurately before submitting your payment. Your registration will not be confirmed until payment is received.

Registration Enquiries:

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