Dear Colleague,

One of our first tasks to hand for 2010 is the collection of the annual membership fee, which is now due. We would appreciate if you could complete and forward this application together with your ( 20 Euro)  fees as soon as possible to our Treasurer: Ms Kathleen Heery, Haemovigilance Officer, National Haemovigilance Office, Irish Blood Transfusion Service
James’s Street, Dublin 8

Title: ________________ Surname: _______________ Forename: ______________

Work address: ________________________________________________________

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Telephone: ___________________ Email: ____________________________

Current position: _____________________________________________________

Type of Membership: