ONLINE REGISTRATION
1. IDENTIFICATION
*: Must be completed, will be used for further communication.
First name*:
Last name*:
Titel*:
Address*:
Zipcode*:
City*:
Country*:
Phone*:
Fax:
E-mail*:
2. REGISTRATION FEE:
are you:
a neurosurgeon (1500 euro),
a resident/trainee (1250 euro)
or an operating nurse (750 euro)?
3. INVITATIONLETTER:
do you need an official invitationletter of our department in order to obtain VISA?
yes  no
4. ACCOMPANYING PERSON:
do you want to bring an accompanying person to the workshop?
yes  no
5. EXTRA NIGHTS:
do you want to stay an extra night in the hotel besides the night of 4, 5, 6 Oktober that are included in the course fee (single room = 95 euro, double room = 110 euro)?
yes  no
If you have questions concerning the filling in of this registration paper, please do not hesitate and contact the course secretary: ilse.noterman@uzgent.be.