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Registration Form

Online seminar: Module 4 – Headaches & Orofacial Pain
Sunday, 9th November 2025; 9:00am – 5.30pm (GMT)

Registration Fee: £180 (GBP) / €218 (EUR)

Name *

First

Last

Email *

Preferred payment method

Bank transfer (in UK Pounds or Euros)
Credit/debit card (payment in UK Pounds or Euros)

Please select preferred payment currency

UK Pound Sterling (GBP)
Euros (EUR)

Do you require an attendance certificate (sent by email after the seminar)?

Yes
No

If you have attended an online seminar with us before, you do not need to fill out the billing details below (unless they have changed).

I have attended an online module with Neuroseminars before.
This is my first online module.

Business Name (if applicable)

Business Number, VAT Number, NIF or CIF (if applicable)

Billing Address

Telephone number

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