REGISTRATION FORM
EASOM SUMMER SCHOOL 2019

TEACHING OCCUPATIONAL CANCERS: EXPOSURE PREVENTION AND RETURN TO WORK
Venue: Rīga Stradiņš University
Adress: Dzirciema street 16, Riga, Latvia, LV-1007
29th to 31th August 2019

APPLYING for Summer School by the 1st of August, 2019
PAYMENT for Summer School until the 20th of August, 2019

Dear colleagues!
Please fill out the registration form of participant. We will contact with you after recieving your registration form in some days. Thank you!
See you in Riga!

Name *
Your answer
Surname *
Your answer
Adress, post code and post *
Your answer
Employer *
Your answer
Employer's address *
Your answer
E-mail *
Your answer
Phone number *
Your answer
Date of registration *
Your answer
Excursion to Riga on the 29th of August *
Excursion to Jurmala and dinner at the restaurant on the 30th of August *
Accompany person in EASOM summer school *
Accompany person in excursions *
Data for the INVOICE: Name of the payer *
Your answer
Data for the INVOICE: Address of the payer, post code and post *
Your answer
Data for the INVOICE: VAT liable *
Data for the INVOICE: VAT number of the payer (if no VAT number, then please note "no VAT") *
Your answer
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