Registration

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Registration Virtual Symposium
Dead line for registration
1^st November

Member	55,00 €
Non Member	75,00 €
Student	50,00 €

Registration Form

Personal Information

First Name *

Last Name *

E-mail *

Phone Number *

Profissional Information

Institute/ Hospital/ Faculty/ Other *

Department *

Scientific activity *

Address *

Zip code *

City *

Country *

Payment *

Member - Registration until 01 November 2020 - 55,00€

Non Member - Registration until 01 November 2020 - 75,00€

Student - Registration until 01 November 2020 - 50,00€

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!

Name for receipt *

NIF/VAT *

Voltar