Registration Seminar Classification & Reporting of Severity

I herewith register for the Seminar Classification and Reporting of Severity at the EUSAAT 2016 / Linz 2016 Congress. I agree to my personal data being stored in the register of participants and that this list can be forwarded (DVR 0842842).

For participants of the EUSAAT 2016 / Linz 2016 Congress this seminar is free of charge. Participants of the seminar who do not also participate in the congress will be charged in advance with € 50,- This registration will be sent to the Congress Office: congress2016@eusaat-congress.eu

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* Required information.
I want to participate in (preferred date) *
date option I - 24.08.2016
date option II - 25.08.2016
date option IIII - 26.08.2016
I want to participate in (2nd choice) *
date option I - 24.08.2016
date option II - 25.08.2016
date option IIII - 26.08.2016
no 2nd choice possible
Salutation *
Miss
Mrs.
Mr.
Title (academic)
Last name *
First name *
Institution *
Department
Street *
Postal code *
City *
Country *
State
Telephone
Mobile phone
Fax
E-mail *
I'm participant in the EUSAAT 2016 congress *
YES - the seminar is free of charge
NO - participation fee for the seminar is € 50,-
Remarks
6