Members' Registration for the EMSA Spring Assembly 2019
Dear EMSAi,

The Organising Committee as well as the EMSA European Board are thrilled to invite you to the EMSA Spring Assembly 2019 which will take place between 24-29 April 2019, in Heidelberg, Germany! The theme will be „Medical Mobility and Migration”. This is the form that you have to complete to register for the event.

#SA19inHD
#Emsa2019SA

Members registrations (22.11-13.12) for members of all FMOs

The participation fee including five nights of accommodation and three course meals and coffee breaks is 220€ .

The fee without accommodation and breakfast, but including lunch, dinner and coffee breaks is 150€.

The local participant fee (without accommodation and breakfast, but including lunch, dinner and coffee breaks) is 150€.

Accommodation will be in Jugendherberge International Heidelberg, Tiergartenstraße 5, 69120 Heidelberg, Germany. The main venue will be around the corner in the clinics (Kopfklinik, INF 400, 69120 Heidelberg; Krehl-Klinik, INF 410, Heidelberg and more).


EXTRAS:

PreSA NC Meeting: The fee is 20 € and will include accommodation (in host houses), the necessary materials, coffee breaks and meals (dinner on the 23rd, breakfast and lunch on the 24th). (ONLY FOR NATIONAL COORDINATOR PROXIES)

PostSA field trip: 29.04 - 01.05. The fee is 80 € Neuschwanstein & Bodensee

The Registration form consists of 8 sections and take around 10mins to process properly. There is a gimmick in the end.

Email address *
Name *
Your answer
Surname *
Your answer
Date of birth *
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/
DD
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YYYY
Country *
If your country was missing from the list above, please specify it here
Your answer
Faculty Member Organisation (FMO) *
If your Faculty Member Organisation was missing from the list above, please specify it here:
Your answer
Your position in EMSA at the time of Spring Assembly 2019 *
For carriers of proxies: Whose voting right will you carry? (For one Faculty Member Organisation, either two Local Coordinators or one proxy carrier is allowed to register at this time.)
Your answer
Phone number *
Don't forget to add your country code, e.g. +90 for Turkey
Your answer
Emergency contact *
Name, relation and phone number of your emergency contact
Your answer
Accommodation *
Food preference *
Have you ever attended a European EMSA Meeting? If yes, please specify the name(s) of the meeting(s):
Your answer
What is your motivation to attend the SA'19? (Your motivation letter will be considered for the selection process and has a limit of 250 words.) *
Your answer
Do you need an Invitation Letter? *
In which form do you prefer to receive your certificate of attendance? *
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