Registration Form

First Name *

Last Name *

E-mail *

Phone Number *

Institute/ Hospital/ Faculty/ Other *

Department *

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Address *

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Registration:

Food restrictions

Dinner (27th March)

27th March Lunch Satellite Symposium

28th March Lunch Satellite Symposium

29th of March Satellite Meeting
Raising awareness in innovative therapies in IMD

Payment *

Payment:
ATM reference- select this option after submit the registration 
Bank transfer - please send the payment document to spdm@its-comunicacao.pt
Millennium BCP NIB: 003300004523557616305

The registration must be validate by SPDM!

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