Care & support at the End of Life

Name *

First name

Last name

Designation

Email address *

Home phone or cell phone *

Postal address *

Address line 1

Address line 2

Address line 3

Address line 4

Town/Suburb

City

Postcode/Zip

Name of workplace *

Work email address

Please indicate below which course date you are registering for. All courses are FREE OF CHARGE, but registration is essential.

Care & support at the End of Life

Thank You for your registration. Your work book will be emailed as soon as we have processed your form. For further information or Queries please email education@hospicesc.org.nz thank you.