Registration Form COEUR Course, Friday 31 January
Please fill in the form below.
Initials *
Your answer
Surname *
Your answer
E-mail address *
Your answer
Institute *
Institute if not Erasmus MC
Your answer
Background *
I will attend the: *
Registration costs

The registration fee for this course is €100 per person. The course is free for Erasmus MC employees.
If you do not work at the Erasmus MC, please transfer €100 to NL33ABNA0426827708 t.n.v. Thoraxcenter Research B.V. for final registration. Final registration will be confirmed later by e-mail.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy