ONLINE REGISTRATION FORM

Cardio-Cath Conference

Please read carefully and follow the instructions mentioned below before completing each field:
Mandatory fields are marked with a red asterisk (*)
 
 
     
  Contact Details  
     
 
       
Surname:   *
Name:   *
Title/Position/Occupation:   *
Department/Hospital/ University/Institute etc:   *
Address:   *
Postal code:   *
City:   *
Telephone: [including country and area code]   *
E-mail:   *
       

[This e-mail address is used for all correspondence regarding registration. Please ensure this address is working properly and check your spam filter settings. Please only enter one e-mail address]
 
     
  Workshop Online Registration Form
limited number of participants
 
 
Workshop: Measuring CT for TAVI (Part I)
THURSDAY, JULY 7th 2016, 18.00 – 20.00
 
Workshop: Measuring CT for TAVI (Part II)
FRIDAY, JULY 8TH 2016, 11.45-13.45
 
     
  Registration for the Course is free of charge. Delegates, who wish to participate, should complete and send the Registration Form to the Administrative-Organizing Bureau by June 30th, 2016.  
     
  After June 30th, registrations can only be made on-site at the Secretariat of the Course.  
     
  Registration includes:

▪ Admittance to the Scientific Program of the Course
▪ Course Material
▪ Certificate of Attendance

The attendance of the whole program is mandatory in order to receive the Certificate of Attendance