Myositis Support Group 
Annual General Meeting and Conference

Saturday 12th July

at

       The Paragon Hotel (click here for details)

145 Alcester Street

BIRMINGHAM

B12 0PJ

REGISTRATION FORM

Attendance to the AGM and Conference is free of charge to members and their partner/carer.   There will be coffee/tea on arrival, mid morning coffee/tea, lunch and afternoon tea and biscuits.  There is a nominal charge of £20 per person for others wishing to attend.

Name(s) of all persons wishing to attend:........................................................................

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Address:........................................................................................................................

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Telephone number: ........................................................

Total number of attendees: ..................

Total number of wheelchair users:....................(the venue is wheelchair/disabled friendly)

I/we enclose a cheque for £.............

(please make cheques payable to the 'Myositis Support Group')

If you have a special dietary request or any other special requirements for the day, please indicate below. we will do our best to accommodate you.

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PLEASE NOTE THAT ADVANCED REGISTRATION IS REQUIRED FOR ATTENDANCE

Please return this form to: The Secretary, Myositis Support Group, 146 Newtown Road, Woolston, Southampton, SO19 9HR