SEUD 2027 - Faculty member - April 22nd -24th - Florence Italy

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Family name*

First name*

E-mail*

Cell phone number*

Essential to ensure a confortable stay in Germany
Please indicate your country ID (+33, +41, +212, etc.)

Accommodation

Do you need accommodation?*

Yes
No

Hotel 4**

Night of April 21st to 22nd (night before congress)
Night of April 22nd to 23rd
Night of April 23rd to 24th

Double room single occupancy, breakfast included.
The Organizing Committee covers 3 nights maximum.
All other extra (double occupancy, extra night, minibar, etc.) has to be paid by yourself at the hotel reception desk.
If you need an extra night or a double occupancy, please fill in the "Special requests" box at the bottom of the page.

Transport

Would you like us to arrange your transportation?*

Yes, I would like you to make my travel arrangements
No, I will make my own travel arrangements

Departure & Return country*

Departure & Return City*

Departure date*

Departure time*

Morning
Afternoon
Evening

Return city (if it is not departure city)

Return date*

Return time*

Morning
Afternoon
Evening

Do you need a checked luggage ?*

Yes
No

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.

Thank you for sending your receipts, your personal mailing address and your bank details after the congress to :
Com & Co
SEUD Registration
3 rue Sainte-Adélaïde 13004 Marseille
Or by email to : registration@seud.org
We will proceed to your refund by bank transfer within 4 weeks, on a 300€ basis for Germans, 500€ basis for Europeans and on a 1000€ basis for the rest of the world.

IDENTITY DOCUMENT

Surname*

Given names*

Nationality*

Gender*

Female
Male

Date of birth*

Identity Document

ID Card (for europeans only)
Passport

Document ID*

Birth place*

Date of issue*

Date of expiry*

SOCIAL PROGRAM

Would you like to attend the gala dinner?*

Yes
Yes and I will be accompagnied by one person (70€ VAT Included)
No

Miscellaneous

Special Requests

Profil picture*

Taille max. des fichiers : 128 MB.

Please provide us a profile picture. This photo will be used for the Congress

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.