EUROPEAN MEDICAL DEVICE LEADERSHIP: Advanced Training Course

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29 - 30 October 2019
Malta Life Sciences Park, San Gwann

ONLINE REGISTRATION

Please submit this form and forward proof of payment to
academy.medicinesauthority@gov.mt by 18 October, 2019

Name and Surname *

Title

Position *

Name of Organisation *

Address *

Contact number *

Email address *

Type of registration *

Early bird registration €1250 (till 15 September 2019)

Trio delegation €2750 (till 15 September 2019) applicable to 3 delegates from same organisation

Late registration €1500

Required

Dietary requirements, if applicable

Data Protection *

I give consent for my personal data to be processed for the purposes of this registration

I consent that this personal data may be used for future events.

Required

Payment details

Payment to be effected via bank transfer as per details below:
Bank HSBC Malta plc.
Gżira Branch
Malta
Account No. 039-011176-002
Swift Code MMEBMTMT
IBAN MT78MMEB44392000000039011176002

Description: AcademyMMA - Medical Devices training
Type of registration and name of attendee(s) on behalf of whom the payment is effected.

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