Certificate in Management for the Medtech and Engineering Sectors Booking Form Note: All field marked * are mandatory. Certificate in Management for the Medtech and Engineering Sectors Sep14 Date: 14th September 2020 - 30th June 2021 Time: 08:30 - 17:00 Duration: 1 Year Blended Learning Venue: University of Limerick. Address: PreRecording. Live Tutorials & 7 classroom days.Online Induction2020 incls 3 classroom days2021 incls 4 classroom days Member price(s): Per delegate: €1,500.00 (plus VAT) Non Member price(s): Per delegate: €2,000.00 (plus VAT) Contact details: Name: Job Title: Company: Telephone: Mobile: Email: Address: County: -Select County- Antrim Armagh Carlow Cavan Clare Cork Derry Donegal Down Dublin Fermanagh Galway Kerry Kildare Kilkenny Laois Leitrim Limerick Longford Louth Mayo Meath Monaghan Offaly Roscommon Sligo Tipperary Tyrone Waterford WestMeath Wexford Wicklow Post Code: Country: -Select Country- Australia Austria Bahamas Barbados Belarus Belgium Brazil Bulgaria Cameroon Canada Cayman Islands China Colombia Congo Croatia Cyprus Czech Republic Denmark England Estonia Finland France Germany Ghana Greece Hong Kong Hungary Iceland India Ireland Israel Italy Japan Kenya Korea, Republic of Latvia Lithuania Luxembourg Malaysia Malta Mexico Netherlands New Zealand Nigeria Northern Ireland Norway Poland Portugal Puerto Rico Qatar Romania Russia Saint Vincent and the Grenadines San Marino Scotland Singapore Slovakia Slovenia South Africa Spain Sweden Switzerland Taiwan Thailand Turkey Ukraine United Arab Emirates United Kingdom United States of America Wales Zimbabwe Number of delegates: Note: As this is not your contact email address, please ensure that the delegate/s knows that you are providing their details to Ibec for direct communications relating to this event/training programme. 1 2 3 4 5 6 7 8 9 10 Delegate(s) Delegate 1: As per Contact details above Name: Email: Delegate 2: Name: Email: Delegate 3: Name: Email: Delegate 4: Name: Email: Delegate 5: Name: Email: Delegate 6: Name: Email: Delegate 7: Name: Email: Delegate 8: Name: Email: Delegate 9: Name: Email: Delegate 10: Name: Email: Special Requirements: Note: List delegate's name and any special requirements.