Voorwoord

Sprekers

Programma

Accreditatie

Locatie & Route

Registration

Registration is accepted according to the 'first come, first served' principle. Participation is only possible for the two days.

The registration fee is 275 euros incl. VAT.

 
Gender:  Mrs.     Mr.
Title:
Name/Initials:
Prefix: 
Surname:
Country:
Phone number (+country code): 
E-mail address:
     
Specialism: 
You are:  physician
fellow in training
Hospital: 
City: 
Country: 
BIG code:   
   
Payment method:  Electronic banking (iDeal, MasterCard, Visa, American Express, Pay Pal and more)
  (this is the only payment method)
  Debit (SEPA, Single Euro Payments Area)

Permission required due to General Data Protection Regulation (GDPR)

Agree that we process your data in accordance with our Privacy Statement and Sponsor Policy.
It is mandatory to fill in this box: otherwise we will unfortunately not be able to register you.

     
Question (optional):

(Fields that are marked with a   are mandatory fields)