ESC Virtual Seminar 2023

1 General info

2 Registration

3 Invoice

4 Payment

ESC Virtual Seminar, 12-13 May 2023

* Mandatory fields

Event Name

Event Date

First Name

Last Name

Institute

Department

Street

Numberyour full name

Postal code

City

Country

Email address (receipt confirmation)

Email address participant (if different from above)

I'm a paid-up ESC Member 2023?

YesNo

Seminar Registration fees - Member

Seminar Fee for Doctor ESC member: 60 Euro Seminar Fee for Non-doctor or Student/Resident in training - ESC member: 0 Euro*

Seminar Registration fees - Non member

Seminar Fee Doctor including ESC membership 2023: 140 Euro Seminar Fee Non-doctor or Student/Resident in training including ESC membership 2023: 70 Euro* Seminar Fee Industry: 200 Euro

* Provide an official letter to confirm your non-doctor or student / resident in training statusupload

* Upload an official letter to confirm the non-doctor or student / resident in training status

Total € [field89 + field90]

Complete your invoice address here, only in case you would like to receive an invoice.

First Name (Invoice)

Last Name (Invoice)

Company (Invoice)

Department (Invoice)

Street (Invoice)

Number (Invoice)

Postal Code (Invoice)

City (Invoice)

Country (Invoice)

VAT Number (Invoice)

Invoice remarks

Email address where to send the invoicea valid email

Correspondence

You will automatically receive congress and society updates.

You would like to receive the following newsletters

Third party correspondence (non-commercial)Third party correspondence (companies)

Third party correspondence (non-commercial) might be information from other societies in the field, partner organisations, interesting publications, journal related information...

Social media

Facebook: https://www.facebook.com/escrh.eu
Twitter: https://twitter.com/ESC_RH
LinkedIn: https://www.linkedin.com/company/3506691/admin/
Instagram: https://www.instagram.com/escreprohealth/

Seminar sponsors

Confirmation

Upon receipt of the registration form, a confirmation will be sent. If for some reason this email does not reach you, please contact the ESC Central Office (info@escrh.eu).

Payment

You will be sent to the payment provider when clicking on the "Pay and submit your registration" button.

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