netmind presentation from conference Bynet 2.0

1. SPECT/CT Course and Workshop
Fundamentals, Instrumentation and Techniques
Organized by the
Biomedical Physics Department, Nuclear Medicine Section, Radiology Department and
Training and Education Office, Research Centre King Faisal Specialist Hospital and Research Centre, Riyadh
22 – 24 Dhu Al-Qada 1430 (10 – 12 November 2009)
APPLICATION FORM
(Please TYPE or PRINT all the information you will enter in this form)
Name: Sex: Male Female Tel. No.:
Job Title: Degree: Fax No.:
Department: Institution:
Country: City:
E-mail: Mobile:
Signature of Applicant: P.O Box or MBC No. Date:
Please choose one from the following:
Course only (no Hands on/ Practical attendance), SR 300
Course and SPECT/CT QC Hands on/ Practical, SR 500
Course and Gamma Camera Hands on/ Practical, SR 500 Students, SR 100
Early registration deadline is 21 October 2009, after this date the fees will be raised by SR 100.
Applicant’s Department Head Approval:
Name: Signature: Date:
Note: Proficiency in English is a must for participation in this Course

2. Please return completed application form by 21 October 2009 to:
Training and Education Office, Research Center, MBC-03, King Faisal Specialist Hospital & Research Centre
P.O. Box 3354, Riyadh 11211, Saudi Arabia, Tel No.: (01) – 464-7272 ext. 32600/39246, Fax No.: (01) – 442-4661
E-mail: rcteoregistration@kfshrc.edu.sa, afayyad@kfshrc.edu.sa