Torna a

Torna a:

Corsi di formazione, aggiornamento, ECM

Instructions for completing:

As regards "Town" field, please enter at least 3 characters, the towns that match what you are typing will appear in a menu, then select the town of interest. The manual input in this field will be discarded.
If the town is not in the list , please write "Not listed" and enter the name of the town in the last field "Membership information and notes".
If residence and address data do not match, please tick the box "Address different from residence" and enter the address data.
If "Medical Doctor" is chosen as profession, it is also mandatory to select the "Discipline".


Symposium
Event MIO LIVE 2018 from 29/01/2018 to 30/01/2018.
Personal information
Surname Name
Date of birth
 (dd/mm/yyyy)
Gender
Place of birth
Country Town
District ZIP code
Tax code
Type of attendee Sponsor
Residence data
Country Town
District ZIP code
Address
Address data Address different from residence
Country Town
District ZIP code
Address
Phone numbers / Email
Telephone Mobile
Fax E-mail
Data for invoice
Address for invoice same as residence address
Country Town
District ZIP code
Address
VAT number
Profession
The field number should be completed by entering the initials of the Province and then the number of the Professional
Register, i.e. RM0000
Registered Registration number
Affiliation
Profession
Discipline
Another Profession (not medical)
Curriculum
Membership information and notes
 
I declare to be aware of the sanctions concerning false statements according to L. 4/1/1968 n°15, L. 127/97 and DPR 10/10/94 n° 403
According to the legislative degree 196/2003, I allow the processing of my personal data for the registration to the symposium
 
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Attualmente non sono aperte le iscrizioni a nessun corso

Non è possibile iscriversi on-line.

For any questions, please contact us at the following email address: valeria.polimeni@unicatt.it

Registration has been successfully completed.
You will receive an email notification to confirm your registration for the symposium.

For any questions, please contact us at the following email address:
valeria.polimeni@unicatt.it

Iscrizione avvenuta regolarmente.
Per un inconveniente tecnico non è stato possibile spedire la mail con la conferma dell'avvenuta prenotazione di iscrizione al corso.

Il sistema proverà ad inviarle la mail in maniera automatica nei prossimi giorni

For any questions, please contact us at the following email address:
valeria.polimeni@unicatt.it