Symposium Aanmelden/Registration

Registration form Symposium 'Health of People on the Move: access to health for refugees en route and in the Netherlands', October 28th 2016

Name*
E-mail*
Affiliation
Profession
BIG-registratienummer
Category*
Payment*
I pay by transferring the correct amount to IBAN account number NL30INGB0000125774 NVTG, Maartensdijk. NVTG member € 85 / student € 55 / PhD student € 70 / other participants € 95
I hereby give permission to the NVTG to withdraw the correct amount from my account number. NVTG member € 85 / student € 55 / PhD student € 70 / other participants € 95
IBAN account number
IBAN account name
The early registration fee is only valid for participants who have paid before October 20th, after that date late registration fee will be charged: NVTG member € 95 / student € 65 / PhD student € 80 / other participants € 105.
 
congresfolder 2016