Medica 2007

Pre-Departure Briefing Attendance Form

Company name *required

Contact person

Title *required ... Dr Miss Mr Mrs Ms Other

First name *required

Last name *required

Phone *required

Email *required

Name of person/s attending pre-departure briefing *required

Please indicate preferred session *required  Sydney - 10.00am Tuesday 9 October 2007  Melbourne - 11.00am Wednesday 10 October 2007  Perth - 9.30am Wednesday 10 October 2007
(video conference with Melbourne)  Brisbane - 10.00am Friday 12 October 2007

Please see networking activities for venues and times

Mandatory field(s) marked with *required