SIM 2018 Congress Registration Form
Surname *
First Name *
Title
Dr, Mr, Mrs, Ms
Hospital *
Address *
Postal Code *
City *
Country *
1. Billing address: University, Hospital, Establishment or Company *
2.Billing address: Organization number or VAT number *
3. Billing address: Postal address or e-mail address *
4. Billing address: Reference number (if applicable) *
E-mail address *
Participation in social programme on Wednesday June 6th *
Wednesday: " Allas Sea Pool Get Together"
Participation in social programme on Thursday June 7th *
Archipelago Cruise
Participation in lunch on Friday June 8th *
Special Diet *
Submit
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