Congress registration | International congress of the Croatian society for burn injuries of the Croatian medical association

PERSONAL INFORMATION

First name *

Last Name *

Title

Organisation *

OIB (Personal ID number)Required for people from Croatia

Address *

City *

Postal/Zip code *

Country *

E-mail *

Confirm E-mail *

Phone number *

REGISTRATION FEE

Registration fee for physicians, nurses, residents and others include:

Attendance at the scientific program of the Congress and the sponsor exhibition
The welcome reception at the congress venue
Working lunches and coffee breaks
Congress materials (program, bag, accreditation)

Registration fee for accompanying persons include:

The welcome reception at the congress venue
Working lunches
Coffee breaks

Registration Fee

200,00 EUR – Physicians100,00 EUR – Nurses, Residents, and Others

ACCOMPANYING PERSON

Would you like to register an accompanying person? *

Yes, there will be an accompanying personNo

Name and surname of accompanying person *

Registration *

Registration not required100,00 EUR – Fee for accompanying persons

ADDITIONAL OPTIONS

Congress dinner for you at a price of 50 EUR? *

YesNo

Congress dinner for the accompanying person at a price of 50 EUR? *

YesNo

ACCOMMODATION

Do you need accommodation in the Congress venue hotel Pinija or in the Falkensteiner hotel Iadera, with the same accommodation prices: *

118,00 EUR/night in a double room/ SINGLE USE /, bed and breakfast basis Congress venue hotel Pinija118,00 EUR/night in a double room/ SINGLE USE, KING SIZE /, bed and breakfast basis Falkensteiner hotel Iadera144,00 EUR/night in a double room/ DOUBLE USE /, bed and breakfast basis Congress venue hotel Pinija144,00 EUR/night in a double room/ DOUBLE USE, KING SIZE /, bed and breakfast basis Falkensteiner hotel IaderaAccommodation not required

PAYMENT

Payment option *

Pay online by credit card (VISA, MasterCard, Maestro, or Diners)Pay via internet banking or bank transfer

INVOICE DETAILS

If you would like the invoice to be made out to another person or company, please fill in all the required information. For an individual, use the full name; for a company, use the company name.

I want the invoice to be made out to:

Same as personal informationDifferent person or company — please fill in the information below

Full name *

Company name *

OIB/VAT ID/ TAX ID: *

Street and house number

Postal code and city

Country

TOTAL AMOUNT TO PAY

Registration

0,00€

Accommodation

0,00€

Extras

0,00€

Total

0,00€