CI 2024 Spain – Inscripcion – Inscribe-t

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CONTACT
GRAN CANARIA

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HOME
INFORMATION
COMMITTEES
ABSTRACTS
- ABSTRACTS GUIDELINES
- ABSTRACTS SUBMISSION
REGISTRATION
ACCOMMODATION
CONTACT
GRAN CANARIA

REGISTRATION FORM – CI 2024 SPAIN

Unique ID
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Categoría participantes
- Delegates
- Speaker
- Organization
- Exhibitor Oticon
- Exhibitor Cochlear
- Exhibitor Medel
- Exhibitor Advanced Bionics
- Exhibitor Suministros Hospitalarios
- Exhibitor Amplifón/Gaes
- Exhibitor Intermedic
- Exhibitor Nurotron
- Invitados
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Laboratorio
- Medel
- Cochlear
- Advanced Bionics
- Nurotron
- Intermedic
- Oticon
- Suministros Hospitalarios
- Innoforce
- Cochlear LATAM
- Tecnosalud
- Cochlear Italia
- IOTAMOTION
- PAM ARGENTINA
Please select:*
- Mr.
- Ms.
Name*
Name Surname
Telephone*
Email*
Position*
Affilation*
Country*
City*
Please select one of the following:*
(Local taxes included).
- Physician (700 €)
- Audiologist (600 €)
- Speech Pathologist (600 €)
- Researcher (600€)
- Student (350€)
- Resident (350€)
Are you a faculty member? (1)
- Yes
- No
Early Bird Fee Applies

Code Required
Please upload an official document that verify you are a student*
Suelta archivos aquí o

Tamaño máximo de archivo: 10 MB.
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Are you attending the Conference Dinner?*
(Not included on the registration fee)
- Yes
- No
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Do you have any food restrictions?*
- Yes
- No
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Please indicate your food restriction:*
- Celiac
- Seafood allergy
- Vegetarian
- Other
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Please specify your allergy:*
REGISTRATION FEE
Physician (Early Bird: 6)
Precio:
Physician
Precio:
Audiologist (Early Bird)
Precio:
Audiologist
Precio:
Speech Pathologist (Early Bird)
Precio:
Speech Pathologist
Precio:
Researcher (Early Bird)
Precio:
Researcher
Precio:
Student (Early Bird)
Precio:
Student
Precio:
Resident (Early Bird)
Precio:
Resident
Precio:
1 day registration (Early Bird)
Precio:
Student Registration (Early Bird)
Precio:
Dinner*
Precio:
Subtotal
0,00 €
Total
(Local taxes included)
0,00 €
INVOICE DATA'S
Issue the invoice to:*
- Corporation/Organization
- Private Person
Name of the Corporation/Organization*
Name (for invoicing porposes)*
Name Surname
Address:*
Direction City Province/State/Region Postal Code
Country*
VAT Number*
PAYMENT
Credit Card*
Credit Car Number
Card Holder