European Surgical Training Workshop Registration Form
The fee for participating in this workshop is 3,200 EUR. This includes three nights in a hotel as well as all meals and beverages. If you register before April 1, 2017, you will benefit from our early bird rate of 2,800 EUR.
Institution Name
Your answer
Full Name
Your answer
Lab PI Name
Your answer
Address
Your answer
Mobile Phone Number
This is very important for any last minute communications.
Your answer
Email Address
Your answer
Subject Type
Please indicate the type of subject involved in your research (human, NHP, rodent).
Your answer
Please tell us a bit about your research.
Your answer
Would you like us to register you for a hotel room?
Hotel rooms for 3 nights are included in the price.
Do you have any dietary restrictions?
Your answer
What are your expectations from this workshop?
Your answer
Preferred Payment Method
Submit
Never submit passwords through Google Forms.
This form was created inside of Blackrock Microsystems Europe. Report Abuse - Terms of Service - Additional Terms