Knowledge Exchange Registration Form

This form is for applying to attend our Palliative Care Conference 2023 on the 2nd November 2023. Please read our privacy statement below and use this form to give Highland Hospice permission to store your data.

If you have difficulties using this form, or you would like more information about the conference before you register, please contact us directly at echo@highlandhospice.org.uk.

Title

First Name

Last Name

Job Title

Employer

Work Address 1

Work Address 2

Town

Postcode

Contact Telephone Number

If you are booking this conference on behalf of someone else, please check the box below and also provide your details. If you are booking for yourself, skip this part and go directly to the permissions.

I am booking on behalf of someone else.

Booked By (if different from above)

Contact Number (if different from above)

Email (if different from above)

Please read the Highland Hospice Palliative Care Conference Privacy Notice below and tick the box to confirm agreement.

I grant permission for Highland Hospice to manage my personal data in connection with the Palliative Care Conference.

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Registered Office: Highland Hospice, Ness House, 1 Bishops Road, Inverness IV3 5SB.
Telephone: 01463 243132. Email: generalenquiries@highlandhospice.org.uk
Highland Hospice is a registered Scottish charity, no. SC011227 and a company limited by guarantee, no. SC093464
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