Registration ITMED'16



REGISTRATION FORM
General information
Title Degree
Family Name First Name
Job Title/position
General information about institution
Company/Institution
Address City
PostCode Country
Phone Fax
E-mail
I am interested in:
participation in the SESSIONS and WORKSHOP
participation in the THEMATIC ROUND TABLES-DISCUSSIONS on HOT TOPICS
participation in POSTER SESSION
participation in the EXHIBITION
I agree to have my personal data processed for The Forum purposes in accordance with the act about the Personal Details Protection Act of 29 August 1997 (Journal of Laws [Dz.U] No. 133, item 883)