Faculty member : logistics arrangements - April 13th & 14th - Lisbon - Encontro a duas mâos

Faculty member : logistics arrangements – April 13th & 14th – Lisbon – Encontro a duas mâos

Faculty member : logistics arrangements – April 13th & 14th – Lisbon – Encontro a duas mâos https://form.comnco.net/wp-content/uploads/2018/12/RA2M-PORTUGAL-SIGNATURE-MAIL-BIS-0611.jpg 520 100 Com&Co Form Com&Co Form 13 décembre 2018 13 décembre 2018

Faculty member : logistics arrangements - April 13th & 14th - Lisbon - Encontro a duas mâos

Thanks for answering within 3 weeks

Family name*
First name*
E-mail
Cell phone number*
City & Country
Accommodation
University Campus - Egas Moniz*
- Night of April 12th (12th to 13th, day before the congress)
- Night of April 13th (13th to 14th)
- I don't need accommodation
Single Room, breakfast included. The organizing committee covers a maximum of 2 nights. The extras and added night will be charged to you (and has to be paid upon arrival). Please keep us informed in the part bellow.
Special Requests
Transport
*
- Yes, I would like you to make my travel arrangements
- No, I will make my own travel arrangements
Departure city*
Departure date*
Departure time*

: Heure

Minutes
Return city (if it is not departure city)
Return date*
Return time*

: Heure

Minutes
Membership card type and number (airline, railroad company...)
Download 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 Requests
Thank you for sending your receipts and your mailing address or your bank details after the congress to :
Com & Co
Julie Trovatello
15 Bd Grawitz - 13016 Marseille
Or by email to : julie.trovatello@comnco.com
We will proceed to your refund by bank transfer within 4 weeks, on a 200€ basis for people from Portugal and on a 350€ basis for European people. If you use your personal vehicle, the allowances of refund will be calculated on a " Mappy " basis.
Miscellaneous
Comments
RGPD*
I certify that I am a healthcare professional.
RGPD*
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.
Phone
Ce champ n’est utilisé qu’à des fins de validation et devrait rester inchangé.

Faculty member : logistics arrangements – April 13th & 14th – Lisbon – Encontro a duas mâos

Faculty member : logistics arrangements – April 13th & 14th – Lisbon – Encontro a duas mâos

Faculty member : logistics arrangements - April 13th & 14th - Lisbon - Encontro a duas mâos

Accommodation

Transport

Miscellaneous