CNART2021 - Registration for Online Conference
16 to 17th October 2021, in Coimbra (Hotel Dona Inês)
Sign in to Google to save your progress. Learn more
Name *
Passport /Citizen Card number *
E-mail *
Contact (cell phone) *
Institution *
Country *
Modality of registration for ESTRO RTT alliance member
Clear selection
Modality of registration for Other countries
Clear selection
Billing Receipt Data
Complete the following fields for receipt issue
Receipt on behalf of *
VAT *
Transfer information:
IBAN: PT50 0018 0003 1525 2539 0205 5
SWIFT/BIC: TOTAPTPL

Please send the payment receipt to socios@art-radioterapia.pt with subject: "CNART 2019".

Note: The registration at the Congress will only be active after payment confirmation.

Late Registration
Late registration after 30th September (plus € 20 in all registration modalities)
The storage and processing of personal data contained in this form is treated confidentially by the organization in accordance with the legal provisions of the privacy policy. *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy