PAROS EPILEPSY MEETING - Pre-registration form

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PRICE : 390 € VAT included
In-person conference

Registration fee includes :
- Access to all scientific sessions
- coffee breaks and lunches

NUMBER OF SEATS IS LIMITED - PLEASE NOTE THAT 2 ATTENDEES PER CENTER WILL BE ACCEPTED AT THIS STAGE. IF YOUR REGISTRATION IS ACCEPTED, YOU WILL RECEIVE A PAYMENT LINK AT THE EARLIEST POSSIBLE.

First/Surname *

LAST/ FAMILY NAME *

COUNTRY *

GENDER *

Male

Female

Email address 1 *

Email address 2 (optional)

SPECIALTY *

Neurologist

Neurosurgeon

Other

IF OTHER, PLEASE SPECIFY

Name and City of your Institution/Hospital/Center/University *

Cell Phone Number *

Allergies/Special diets

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