Symposium Aanmelden/Registration

Registration form Symposium 'Engaging communities in sickness and health. Something old, something new, something borrowed, something blue' October 22nd, 2014

Name*
E-mail*
Organization/affiliation
Category*
Payment*
I pay by transferring the correct amount to IBAN account number NL30INGB0000125774 NVTG, Maartensdijk. NVTG member € 75 / student € 50 / other participants € 85
I hereby give permission to the NVTG to withdraw the correct amount from my account number. NVTG member € 75 / student € 50 / other participants € 85
IBAN account number
IBAN account name
Early registration fee is only valid for participants who have paid before October 15th, after that date late registration fee will be charged: NVTG member € 80 / student € 55 / other participants € 90.
 
congresfolder 2014