Registration form

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UAAT-ICU Workshop REGISTRATION FORM

Personal and Contact details

Name and Surname
Email

Other informations

(Max 35 characters with space)

Invoicing details

(Correct invoice details are required. No amendments after payment will be possible.)
Who covers the expenses connected with your participation at the event?
Address

Fee section

Please choose registration fee:
0,00 €

Payment section

How would you like to pay?