Biomedical Scientists Adding Value to the Health Care System
REGISTRATION FORM (Please use capital letters or typewriter throughout)
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Contact telephone number (with international code) *
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E-mail address *
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Cost
Standard registration (Professionals and post-graduate students) – 85 Euros
Undergraduate Students – 40 Euros (Current valid student card to be presented at registration desk, failure to comply will lead to full registration rate)
Fee
Payment
The payment method is through credit transfer to the bank account below
Receiver: EPBS aisbl – Place J. Jacobs, 3 – 1000 Brussels (Belgium)
Bank Institute: ING – Avenue Marnix, 24 – 1000 Brussels (Belgium)
IBAN: BE26 3630 1139 6429
BIC: BBRUBEBB

To identify your bank transfer, please indicate your participants names and the organization on the payment
Please note that all transactional costs are your responsibility and must be paid in addition to the fee

Registration is not complete until payment has been received

A copy of your responses will be emailed to the address you provided.
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