online registratio

+38 (044) 537 52 77

ulae2018@ulae.org.ua

CME ACCREDITATION: 20 CREDIT POINTS!

Title :

E-mail :

Surname :

Position :

Place of work :

Address :

Phone :

Sending a form....

Помилка сервера.

Your registration was received”

First name: :

I would like to attend the following

ULAE BURSARY (10 available 150 euro/each) to be paid 100 euro

ILAE-CEA BURSARY (10 available 150 euro/each) to be paid 100 euro

EAST EUROPEAN COURSE OF EPILEPSY (Chapter member) to be paid 250 euro

EAST EUROPEAN COURSE OF EPILEPSY (nonmember) to be paid 300 euro

Arrival date:

Departure date:

Please, check this box if you want to stay in the hotel more than 4 nights (June 12th -16th ). In this case should be paid additional fee 20 euro/per night

Обов'язкові поля

General quantity of nights 4

Please book accommodation for me (1 place in double room)

Please book accommodation for me (single room)

Gender (important for room allocation):

Departure date

Arrival time

Flight number

Arrival date

Departure time

SPECIAL REQUIREMENTSPlease let us know if you have any special dietary requirements (food allergies etc) or if you are a vegetarian or vegan so that we can make provision for you. For vegetarians, please specify if you eat cheese or other products from milk.

Flying from

Kyiv Borispol International airport

Kyiv Zhulyany International airport

Flying to:

Kyiv Borispol International airport

Kyiv Zhulyany International airport

Please write (type) your e-mail very clearly so that we are able to read it and will email information to you before the course

DEADLINES: • 1 June 2018 – Registration extendednded

BOOKING:

Costs include registration fee, 4 nights accommodation in double rooms (June 12-16th 2018), all meals, had outs materials, social program and 2-ways transfer

My flight details are:

foundation@rimon.in.ua

www.rimon.in.ua

Technical organizer

« Projects Inn » LLC

CONGRESS ORGANIZER AND SUPPORT / EXHIBITION CONTACT

Charitable foundation Research Innovations in Medicine “RIMON”

Ukraine, Kyiv, 01001, Business centre «Panorama»

Velyka Zhytomirska st., 20, 9 fl.

Tel/Fax: +380445375277,

E-mail: foundation@rimon.in.ua

http://ulae.org.ua/eece/2018