Registration form
Title. Name *
Your answer
Identity document-Pass/B.I./C.I.: serial NR: *
Your answer
Specialisation *
Your answer
University/Dental office: *
Your answer
Adress (corespondence): *
Your answer
Telephone Nr. *
Your answer
Email *
Your answer
Dietary restrictions *
Registration fee
Early bird (until 1stJune 2017)
Regular registration
On site registration
WFLD/SRLS/SPIE Members
Non-members
Phd/Master/specialization students/young doctors
Last year students
Accompanying persons
Gala Dinner
Payment method : *
Payment details
Account holder:Asociaţia SRLS
SWIFT Code : BTRLRO22TMA
CIF 15289846
Adress: Str. Intrarea Doinei nr.1, Timişoara, Romania


Please send via e-mail to our secretary a copy of the payment documents

Conference Secretary

Tel: +40-768-262643 Fax:+40-256-221488
E-Mail: congress.srls@gmail.com Web: http://lasercongress-srls.com

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