LEUKEMIA 360 2026 - Faculty member : logistics arrangement

Email

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

Profil

Title*

Last name*

First name*

Email address*

Mobile phone number*

Please indicate your phone country code (+33, +34, +39, +41...)

Affiliated medical center*

City*

Country*

Accomodation

Transportation

Airport transfers will be handled by the organization. You will receive detailed information few days before your departure within your road book. If you wish to make your own travel arrangements, please make sure to let us know your travel details so that we can arrange your transfer. f you wish for a specific transfer service, we invite you to contact a taxi transfer agency in order to proceed with the payment directly.

Departure country*

Departure city*

Return country (if different from return country)

Return city (if different from departure city)

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

Preferred Airline company, seat, or special travel request

Reimbursement

We reimburse transportation costs up to a maximum of an amount we will send you by email. A reimbursement form will be sent at the end of the congress.
If you use your personal vehicle, the allowances of refund will be calculated on a national kilometers referral.

Identity information

⚠️ Warning :

This information will be used to arrange your transportation. Please ensure that the details provided below are entered exactly as they appear on your passport or national ID card.
Any inaccuracies may result in boarding being denied by the transport providers, in which case the responsibility will rest with you.

Name used (current surname as shown on the passport/ID card)*

Birth name*

First name (s) (as shown on the passport/ID card)*

Nationality*

Place of birth*

Document Number*

Country of issue*

Social programm

Please indicate any allergies or specific dietary requirements