Registration form *please fill all data
PROFESSIONAL DATA
Name* Surname*
Hospital/Institution*
Department Role
Address* City*
Country * Zip Code*
State*
Ph. * Fax
E-mail*
PERSONAL DATA
Private address* City*
Country* Zip Code*
State*
Ph.* Fax
Mobile*
Private E-mail*


COMPULSORY FOR ALL PARTICIPANTS
Invoice made out to*
Address* City*
Country* Zip code*
State*
TAX n.* VAT n. ​​(if not applicable repeat the Tax/Fiscal Code)*
E-mail to send the invoice*
RISERVATO ALLE SOLE AZIENDE OSPEDALIERE for Italian participants only
In caso di richiesta di emissione fattura nei confronti di enti esenti IVA (A.S.L./A.O.) il partecipante dovrà farne richiesta al momento dell'invio della scheda di iscrizione. La A.S.L./A.O. è tenuta a inviare a My Meeting l'autorizzazione nominativa del partecipante al corso e tutti i dati necessari all'emissione della fattura elettronica (codice univoco); Il pagamento della quota esente IVA dovrà essere effettuato vista fattura.

REGISTRATION FEE:
 
Regular EURO 150,00
 
Resident EURO 100,00

*Proof must be provided by the Director of the Program

 
Student* EURO 0,00

*Proof must be provided by the Director of the Program

 
HOW TO PAY
 
Credit Card [PAY NOW]
 
Bank Transfer
 
PRIVACY
Consent statement to data processing (EU 679/2016 - GDPR)
I hereby authorize My Meeting S.r.l. to process my identifying and/or sensitive personal data in the ways and for the purposes indicated on the information sheet https://www.mymeetingsrl.com/privacy.php
I consent    I do not consent

I hereby authorize My Meeting S.r.l. to process my personal data for commercial and marketing purposes connected to this event and other similar CME events, as well as to send information on promotional activities, advertising material and commercial communications.
I consent    I do not consent

The data controller is My Meeting S.r.l., with its registered office in Via 1 Maggio n. 33/35 in Ozzano dell'Emilia, Bologna, Italy. My Meeting S.r.l. guarantees exercise of rights pursuant to EU Regulation UE 679/2016, including but not limited to, articles 15,16 and 17, to request cancellation, update or modification of personal data to be processed. The data controller can be contacted by email for the above-mentioned purposes: info@mymeetingsrl.com.