ELEC 2027 - Logistics support for faculty

Email

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

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*

N° RPPS (only for french physician)*

If you do not have an RPPS number, please note in this section "N/A".

PHOTO

For the promotion of the congress, we kindly ask you to send us a royalty-free photo of yourself (portrait format), suitable for publication.

Upload your photo*

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

ACCOMMODATION

Select the night(s) according to your wishes*

Night of February, 28th (28th to 29th)
Night of March, 1st (1st to 2nd)
Night of March, 2nd (2nd to 3rd)
I don't need accommodation

This package includes a single room for two nights at the hotel. Depending on your travel arrangements.

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.

Do you need a transportation booking?*

Yes, I would like for you to book my transport
No, I will book my own transport and be reimbursed

Departure city*

Departure date*

Please prioritize arrivals on Monday morning, as the congress will begin at 1:45 PM.

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

Special travel requests (aisle, window...)

PASSPORT

Birth Date

We will reimburse you up to :
– France : 350€
– Europe (out of France) : 700€ Please send your receipts and your bank details after the course to : registration@elec-ir.com We will proceed to your refund by bank transfer within 4 weeks after the conference depending of your departure country. If you use your personal vehicle, the allowances of refund will be calculated on a standard kilometers referral.

SOCIAL PROGRAM

Faculty Dinner - Monday, March 1st*

Yes, I take part to the faculty dinner
No, I do not take part to the faculty dinner

GDPR*

I certify that I am a healthcare professional.

GDPR*

By clicking on 'Send', I confirm that I have read and understood our Privacy Policy and consent to the processing of my personal data by COM&CO EVENTS, in accordance with the said Policy, in order to best respond to my registration request.

I authorize that my personal data be transmitted to the industrial partners participating in the event, for exclusively professional purposes.

ELEC 2027 – Logistics support for faculty