AMSC 2022 - Preregistration form
Please fill in the form below to complete preregistration for the Antwerp Medical Students' Congress (AMSC) 2022. Preregistration is only required to be an active (= presenting) participant. You can find more information regarding active participation (including travel grants) at https://www.amsc.be/active-participation.

You can preregister as an active participant until Sunday 26 June 2022. Don’t postpone it for too long however. The sooner you submit your abstract, the sooner we can get back to you with the decision of our jury.
Moreover, as we only have a limited amount of spots in our workshops, the earlier you preregister and purchase your tickets for AMSC 2022, the higher the chances that you will receive invitations to the workshops of your preference. AMSC ambassadors also have a higher chance of getting their preferred choices, regardless of their time of registration. You will be able to pass along your preferences in the weeks leading up to AMSC 2022 through a form that we will send you via email.

If you wish to be a passive (= non-presenting) participant, you can register directly at amsc.be/register.

The academic programme of AMSC will take place from 13 to 16 September 2022, in person (physically), in Antwerp, Belgium. More details regarding the social programme and possible hybrid elements will be revealed when full registration opens. For more information, visit amsc.be/programme.

Check out amsc.be/faq for frequently asked questions. If you can't find an answer to your question there, let us know at info@amsc.be.
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Middle Name(s)
Date of birth *
MM
/
DD
/
YYYY
Gender *
Nationality *
Mobile phone number *
(Preceded by the proper country calling code, like +32 for Belgian phone numbers, e.g. +32415926535)
Address (street and house number) *
(legal residence or domicile)
Postal code *
(legal residence or domicile)
City *
(legal residence or domicile, use English name if existent)
Province/state *
(legal residence or domicile, use English name if existent)
Country *
(legal residence or domicile, use English name)
Post office box (optional)
(legal residence or domicile)
Do you need a travel visa and an invitation letter from us to apply for it? *
If you need an invitation letter from AMSC, please also request one by sending an email with 'INVITATION LETTER' in the subject to secretary@amsc.be AFTER purchasing your tickets. This way we can get back to you as quickly as possible after purchase. We can only provide you with an invitation letter if you have already bought a ticket.
If you need an invitation letter from us, please provide your passport number.
University *
(use English name if existent)
Country of university *
(use English name)
Study major *
Year of study at university *
E.g. if your study program is structured as 3 bachelor years and 3 master years, and if you are in your 2nd master year, then you are in your 5th year of study.
Type of student *
E.g. if you have already earned your bachelor's degree and are now studying for a master's degree, you are a (post)graduate student.
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of European Medical Students' Association Antwerp vzw. Report Abuse