Participant Registration Form
XIIIth National Forum of Healthcare Professionals with International Participation
"Healthcare - present and future"
10-11th November 2017
Shumen, Bulgaria
Full Name
Your answer
Professional Identification Number
Your answer
Personal Identification Number or Passport Number
Your answer
Place of Residence / Country, Town, Address
Your answer
Current Job
Your answer
Phone Number
Your answer
Your answer
Type of Participation
Registration fee
Paid Fee
Please write down the number and date of the payment order for paid participation fee.
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Official Dinner - 30 leva
I would like to receive an invoice
Invoice Details
Your answer
This registration form is filled in by each participant regardless of whether they present a report, a poster, or they are in co-autorship.
The participants organize their stay on their own during the conference !
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