Register for the Advanced Surgical Anatomy Course

On acceptance (notification by email), you will be invited to pay the course fee either in full or by using an instalment plan. Your full registration for the course will be confirmed by email once payment has been received. You need to achieve full registration to guarantee your place on the next course.

Please note: The level of interest in this course often exceeds the number of places (18). Full registration will guarantee you a position on the course.

1. Registration

I am registering for:*

Semester 1 (2023)

Semester 2 (2023)

If Semester 1 is full, I will register for Semester 2, 2023*

Yes

No - but retain my Expression of Interest

2. Personal details

First Name:*

Last Name:*

Full name with preferred title (this is the name that will appear on your course completion certificate):*

Gender

Male

Female

Other

3. Contact details (for correspondence only)

Address:

City/Suburb:

State:

Postcode:

Mobile Phone:

Work Phone:

Email 1:*

Email 2:

You can provide up to 2 email addresses. We will send all correspondence to both. Email 1 will also be used to officially register you onto UQ's Blackboard (online) so you can access and download all course information.

Vehicle registration number (This is required if you'd like us to organise your parking permit for the course)

4. Educational qualifications

Qualifications:

5. Employment details

Position:

Hospital:

Specialty:

6. Reason for enrolling in this course

Reason

7. What now?

You will receive an email acknowledgement that your application form has been received. If this does not happen within 3 business days, please email the ASAC team at med.enquiries@uq.edu.au