1. Registration

Registration

* 1. Registration

* 2. Position

* 3. Member of scientific society

* 4. Friday morning workshop (limited - first come first serve) (€25,-)

* 5. Networking Dinner Ticket {price is included in the registration fee, extra guests are welcome for €50,-)

  0 1 2 3 4 more than 4 (please e-mail)
number of participants

* 6. Please transfer the money for your registration fee, the optional workshop and optional extra guests at the networking dinner to:

Bank Name:                            ING BANK DK Zuid-Holland
Bank Adress:                          Schenkkade 65, 2595 AS DEN HAAG
IBAN:                                     NL07INGB0651205611
SWIFT:                                   INGBNL2A
Account Name:                       LUMC Divisie 1 
p/a Projectenbureau, Postbus 9600, 2300 RC Leiden
Project Reference Number:     ESVS 70786-8204
Do not forget to mention your full name

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