Registration Form

REGISTRATION FORM

Title *

Name *

First

Middle

Last

Institution (if a student, please indicate the University and year of study) *

VAT Number (only for payments by organizations)

Invoicing address *

Phone number (including Country Code) *

Email *

Early rate until midnight, April 16th, 2023 *

Will you attend the Conference Gala Dinner? Please feel free to bring accompanying persons to Gala Dinner. *

Please let us know your choice. The cost of the Conference Dinner will be added to your invoice.

Accept Data Use Agreement *

By registering for this Conference, you (the delegate) agree that your personal data will be processed for registration and handling purposes, as well as to send you information in connection with the Conference. Any personal data will be solely used in accordance with current EU data protection legislation(GDPR) and will not be disclosed to a third party without the delegate’s written consent. If you do not submit the data indicated as “required”, we cannot complete your registration.

What is included?

Student, IFMBE Member and Non Member fee includes a Participant Badge with a flash memory containing Conference materials, access to all lectures and sessions, publication costs, three coffee breaks with snacks on each day of the Conference, refreshments.