13-16 May 2012, Ghent

Registration - payment - cancellation

REGISTRATION

You can register for the workshop by filling in the registration document below.
Online registration must be made before 23 April 2012!

The registration fee (neurosurgeon: 1500 euro, resident/trainee: 1250 euro, operating nurse: 850 euro) includes:

Endoscopic training (all sessions)

Hotel accommodation in the Holiday Inn Express hotel for 3 nights (13, 14, 15 May 2012)

Welcome reception on Sunday evening (13 May 2012)

Social program on Tuesday evening (15 May 2012)

All meals (breakfast, lunch, dinner and coffee breaks)

DVD Endoscopic Neurosurgery (author: prof. Dr. J. Caemaert - Dr. F. Dewaele)

PAYMENT

Payment must be made by transferring the amount to the scientific account of the Ghent University Hospital. After registration you will receive the payment information.

CANCELLATION

Cancellation must be made by e-mail before 23 April 2012. For cancellation made after this date, we reserve the right to charge half the participation fee. Refunds will be made after the workshop.

Online registration

1. Last name (required)
2. First name (required)
3. Title (required)
4. Address (required)
5. Zipcode (required)
6. City (required)
7. Country (required)
8. Phone (required)
9. Fax
10. Email Address (must be completed, will be used for further communication)
11. Your Message I wish to participate in the 16th international endoscopic neurosurgery workshop on 13, 14, 15 and 16 May 2012 in Ghent, Belgium.

2. REGISTRATION FEE:
are you:
a neurosurgeon (1500 euro), a resident/trainee (1250 euro) or an operating nurse (850 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 nights of 13, 14, 15 May 2012 that are included in the course fee (single room or double room: 99 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.