ESTC Courses Members   World Links Contact
Introduction Information Program Registration  

International Salivary Gland Society
European Salivary Gland Society

Registration Form


European Academy of ORL

PERSONAL DETAILS

Please fill all the mandatory fields marqued with *.

Please register me to the:
16th International sialendoscopy Hands-on Course, Clinique Générale Beaulieu, Geneva, Switzerland, 19 - 21 September, 2011 (extra cost of € 50.00).

 Participant
Resident (with confirmation letter from Department)
Nurse
  Two participants from the same department: 15% off total price. Participants wishing to attend at the same time beginner's and advanced course: 15% off total price (please contact the course secretariat
info-smb@beaulieu.ch).

Titel    Activity   

First name*
   Last name*
 
Address*

Address (Continued)

City*

Post code/ZIP*

Country*

Telephone*

E-mail* (please provide a valid email address)

ESTC Geneva - Switzerland