Neonatal Resuscitation Program (NRP)

Neonatal Resuscitation Program (NRP)
Name : Mr / Ms / Dr. __ ( )
In Chinese
Occupation & Rank :
________________________ Hospital / Dept: _______________________
Correspondence Address:________________________________________________________
E-mail address (for online exam use:) _____________________________________________
Telephone : Mobile - ___________ Residence/Pager - ________________
Course Date*: □ Class 1 : 14 July 2012 (Sat)
□ Class 2 : 12 Aug 2012 (Sun)
□ Class 3 : 2 Sep 2012 (Sun)
□ Class 4 : 21 Oct 2012 (Sun)
□ Class 5 : 18 Nov 2012 (Sun)
□ Class 6 : 2 Dec 2012 (Sun)
Time: 09:00 – 18:00
Course fee: $2,000.00 – textbook, online exam and NRP Provider Card included
Collect course manual: Self-collect HK$50 (Courier Service) (Internal Mail for H.A. staff)
(Reminder for candidate who choosing internal mail, our centre will not be responsible for mailing lost)
Delivery Address: as above correspondence address
Notes :
Others:_________________________________________________________
- No Refund will be made unless the course is over-subscribed or cancelled;
- If the course date preferred is over-subscribed, alternative courses will be suggested.
- $100 handling fee is required if course date is requested to be changed by the student after
payment has been confirmed;
- Participant will be notified to collect the course materials by email at least 6 weeks before
course date
- The online exam code will be emailed to you one month before the course date.
- If no email is received 2 weeks after the submission, please contact us . Tel: 3553 3300
- In order to ensure multi-disciplinary interaction in the courses, the enrollment is not handled
in the first come first serve basis.
Signature: Date :
Payment method: 1) Cheque payable to “ Hospital Authority” together with application form send to the
following address at least 14 working days in advance
Mailing Address: Finance Department, 4/F Ruttonjee Hospital,
266 Queen’s Road East, Wanchai, Hong Kong
2) Payment by cash or EPS will be accepted at Shroff, G/F Ruttonjee Hospital
Shroff opening hours
Mon – Fri : 8:50am – 1pm, 1:30pm – 5pm
Sat : 8:50am – 1pm (closed on Sunday & Public Holiday)