Registration

Registration is accepted according to the 'first come, first served' principle. Participation is only possible for the entire week.

For endocrinologists and fellows in training € 850.
This does not include a hotel room.
If you want to stay overnight, you must reserve a room yourself at  Mercure Amsterdam City Hotel.

Gender:		Mrs.     Mr.
Title:
Name/Initials:
Prefix:
Surname:
Country:
Phone number (+country code):
E-mail address:
Specialism:
You are:		endocrinologist fellow in training
Hospital:
City:
Country:
BIG code:
Accommodation:		exclusive hotel stay     If you want to stay overnight, you must reserve a room yourself     at  Mercure Amsterdam City Hotel.
Payment method:		Electronic banking (iDeal, MasterCard, Visa, American Express, Pay Pal and more)
(only electronic banking)		Debit (SEPA, Single Euro Payments Area)
Ascription:  Address:  Postal code:  City:  Country:  IBAN number:    You can enter your IBAN number above. BIC code:        Select a bank for your BIC code. If unavailable you need to bring your complete BIC code.
Toestemming nodig i.v.m. Algemene verordening gegevens­bescherming (AVG) Akkoord dat wij uw gegevens verwerken conform ons Privacy Statement en Sponsorbeleid. Dit vakje verplicht invullen: anders kunnen wij u helaas niet registeren.
Question (optional):
(Fields that are marked with a   are mandatory fields)