JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
EMEAC Day Registration form
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name/ Family Name
*
Your answer
Country
*
Your answer
Your speciality
*
Your answer
10.15 am-11.15 am CEST: Do you plan to attend the General Assembly ?
*
Yes
No
11.30 am-12.30 pm CEST : SELECT YOUR ORAL COMMUNICATION' SESSION ( you can choose only one)
*
Epilepsy
Nerve conduction and sensation
Theoretical analyses
Miscellaneous
1.30 pm-3.15 pm CEST : SELECT YOUR HIGHLIGHT POSTERS' SESSION ( you can choose only one)
*
Therapeutics/Auditory and Autonomic/ Dystonia/ DBS
EEG/Epilepsy
IoM/ NMD
Nerve conduction/Miscellany/motor control
I agree to receive e-mails from EMEAC for future information regarding this day
*
I Agree
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
