Registration Form

Registration online is free of charge.

Please fill in the form.

Once registered, you will receive a confirmation email from our Organizing Secretariat.

Registration includes the certificate of participation and the CME certificate.

PERSONAL DATA

Name
Last Name
Fiscal code (Italian only)
Birth place
Date of birth
Month
Year
Address
Zip Code
City
Country
Phone number
E-mail
CME Profession
CME Specialization
Order registration number (italian only)
Professional Category (italian only)
Specificare la professione se NON ECM
campo nascosto
Please select the dates you want to attend
- NOVEMBER 11

INSTITUTION

Institution/Company
Address
Zip Code
City
Country

PRIVACY

Authorisation to process personal data based on the information pursuant to Reg. EU 679/2016. The data will be used for secretarial purposes and may be transmitted to suppliers involved in the event in question. The provision of such data is mandatory for the registration to the event. The owner of the data is Events srl. The check in the box below "I agree" constitutes the acknowledgement of this information and allows the processing of personal data as mentioned above. The present authorizes the publication of any photographs taken during the event. For the complete information please read it by clicking on the pulsant

By clicking on 'I Agree' you are confirming that you have read, understood, and accept the Terms of Use and the Privacy Policy.
- I Agree

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Registration Form