ER Congressi

Individual registration

T-CELL BASED IMMUNOTHERAPIES FOR LYMPHOID MALIGNANCIES

from 06-20-2022

to 06-22-2022

Step 1

Your data

Email*

Step 2

Personal data

Name*

Surname*

Phone number please specify the country code

Address*

Zip code*

Nation*

City*

Birth date*

Birth place

Fiscal code (only for italian attendees)*

Career*

Discipline*

Institute

Step 3

Sponsor

I, the undersigned, aware of the sanctions provided by the art. 76 of the Consolidated Law, D.P.R. 28712/2000 n. 445, and the forfeiture of benefits provided for by the art. 75 of the same Consolidated Law in the case of false statements, under my own responsibility, DECLARE

that I was not recruited by any company to attend this event

that I have been recruited by (Insert the name of the sponsor)

N.B. A healthcare professional is considered to be recruited when, for the participation in educational events, he/she benefits from economic and non-economic advantages, direct and indirect, by commercial companies operating in the healthcare field.

Are you interested in obtaining CME credits?

Yes

I will attend on these days:

06-20-2022

06-21-2022

06-22-2022

Company details

Company / Individual name*

Email PEC/CDU*

Vat/Tax ID*

Fiscal code (only for italian attendees)*

Address*

Zip code*

City*

Province*

Nation*

Payment amount