Date of conference: Tuesday 10 June 2008
Please print out and complete the form. Many thanks.
| Title: | _________________________________________ |
| Forename: | _________________________________________ |
| Surname: | _________________________________________ |
| Job Title: | _________________________________________ |
| Firms Name: | _________________________________________ |
| Tel. No: | _________________________________________ |
| E-mail: | _________________________________________ |
| Address: | _________________________________________ |
| _________________________________________ | |
| _________________________________________ | |
| _________________________________________ | |
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| I enclose a cheque payable to: Merseyside Asbestos Victims Support Group. | |
Please enclose a cheque payable to: Merseyside Asbestos Victims Support Group.
and post it with the form to the address below: