ECC 2022 - All inclusive package

Family name*

First name*

E-mail address*

Cell phone number*

Cell phone number (only) Please indicate in front of your phone number, the country dialling code of your country.

Affiliated Medical Center*

Country*

City*

ACCOMMODATION

Select the night(s) according to your wishes*

Night of June 22nd (22nd to 23rd)
Night of June 23rd (23rd to 24th)
I don't need accommodation

This package includes a single room for 2 nights at the hotel. All the information concerning your hotel will be given to you before the event.

Special accommodation requests

TRANSPORT

Airport and/or station tranfers will be handled by the organization. You will receive detailed information in your travel book few days before your departure by email.

Your flight will be in economic class, if you wish to travel in business class, you will be charged personnally.

Do you need a transportation booking?*

Yes
No

Departure city*

Departure date*

Departure time*

Morning
Afternoon
Evening

Return city (if it is not departure city)

Return date*

Return time*

Morning
Afternoon
Evening

Membership card type and number (airline, railroad company...)

Preferred Airline company

Upload your passport or ID Card*

Types de fichiers acceptés : jpeg, jpg, png, pdf, gif, Taille max. des fichiers : 128 MB.

Essential to book your travel. Thanks.

Special travel requests (aisle, window...)

SOCIAL PROGRAM

ECC Dinner - Thursday, June 23rd*

Yes, I take part to the gala dinner
I will be accompanied by one person (60€)
No, I do not take part to the gala dinner

Name

Ce champ n’est utilisé qu’à des fins de validation et devrait rester inchangé.