VII Cell Culture and Tissue Training Course

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Registration

电子邮件地址 *

Name *

Working Place *

Phone *

VAT/NIF *

Address *

Zip Code *

City *

Country *

I hereby consent my email contact to be revaled in the participants list

I hereby consent and authorize the use of, any and all photographs or audio/visual materials for promotion, education or exhibition

Academic Degrees *

Course Attendance *

Theoretical course (student): 25€

Theoretical course (non-student): 50€

When different than participant, payment receipt made to (add name, VAT/NIF, address, zip code, city and country):

Payment

By Bank Transfer
Account’s name: ACIMAGO
Bank Name: Santander Totta
NIB: 0018 0003 39227160020 83
IBAN: PT50 0018 0003 39227160020 83

Please send a fax or e-mail with the transfer confirmation.

Your registration will be effective only after acceptance and payment of the course fee.

Contact

Cláudia Caridade
Centro de Investigação em Meio Ambiente, Genética e Oncobiologia - CIMAGO

Faculdade de Medicina – Pólo III
Azinhaga de Santa Comba, Celas
3000-548 Coimbra

Phone: 239480240 Fax: 239480258
Email: acaridade@fmed.uc.pt

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