INSIDER MEDICAL

MRCS Part A Course

APPLICATION FORM

Surname / Forenames
Title / GMC Number (if applicable)
Home Address / Work Address
ST Level / Specialty / Specialties
Contact telephone number(s) / *Email address (ESSENTIAL)
Course Date (please select): / Sunday 10th December 2017 (MRCS Part A Course) □
Electronic bank payment has been arranged □
Cheque Payment enclosed □
Cheques are made payable to: Insider Medical Ltd / Part A Course £350 □
Part A course includes a complimentary textbook, a comprehensive course pack, all handouts, lunch and all refreshments.

Please type or print.

Accepted payment options:

i) Electronic Bank Transfer (preferred):

Account name: INSIDER MEDICAL LTD
Account: Natwest Bank Bayswater, London

Account number:60070048
Sort code: 60-02-08
Iban - GB66NWBK60020860070048 the IBAN BIC (swift) NWBKGB2L

When you have arranged for payment please email us at . We will then confirm receipt and provide you with the necessary details.

Please note that overseas applicants remitting their course fees electronically through their bank are required to add £20 to the course feein order to cover administrative costs incurred inthe UK (visa fees, telegraphic transfer fees, international currency conversion fees).

ii) Cheques or Bankers Drafts:

Please post your completed application with full Payment to:

(Cheques made payable to: Insider Medical Ltd)

Insider Medical Ltd
Suite 18, Richard Burbridge Mansions

Harrods Village

1 Brasenose Drive

London SW13 8RB

United Kingdom

  • Venue: Central London
  • Your place on this Course will only be secure when your application and payment is received. Registration packs will then be sent. All cheques must be received 7 days prior to the course date, otherwise only electronic bank payment or cash at registration will be accepted.
  • Please note post-dated cheques will not be accepted.
  • Course certificates and receipts will be provided at the time of course completion.
  • For further information, please contact Insider Medical:

Telephone: 07989331573 or 07886205399

Email:

Websites: and

Terms & Conditions:

Please note there is a 10% administration charge for any cancellations up to 15 working days prior to the course. There is a 50% cancellation fee for any cancellations 5-15 working days prior to the course. Cancellations within 5 working days of the course are non-refundable. * Enrolment in the “Insider’s Guarantee to Success” Programme entitles the candidate to a 50% discount on a subsequent MRCS Part B / Clinical course if the candidate fails MRCS. Subject to receipt of proof of failure from the Royal College of Surgeons.