Registration Form

 
Congress Management: Ralcom Exhibitions srl
20A Răspântiilor St., 020548 Bucharest - 2, Romania
Phone: +40-21-211 15 41, 210 65 40; Fax: +40-21-212 27 02; e-mail: registration@romtransplant2014.ro

AFTER YOUR ONLINE REGISTRATION, IN CASE YOU CHOOSE TO PAY BY BANK TRANSFER, 
PLEASE SEND US BY FAX / E-MAIL THE DOCUMENT PROVING THE PAYMENT OF THE SERVICES ORDERED.

The Organizers thank you in advance for a detailed completion of your coordinates enhancing therefore the communication related
to the 2014 ROMTRANSPLANT Congress
  • Step 1
    PARTICIPANT
  • Step 2
    REGISTRATION FEE
  • Step 3
    SOCIAL PROGRAM
  • Step 4
    LIABILITY
  • Step 5
    Payment Methods
  • Step 6
    Preview / Submit
 
PARTICIPANT
The sections marked with * are mandatory.

Personal Information  
Title 1 (*)


Title 2





First Name (*)
(Please indicate full name)
Last Name (*)
(Please indicate full name)
Organisation (*)
Head of department

Specialty (*)

Mailing Address 
No., St., Block, Apt. (*)
Postal Code (*)
City & District (*)
Country (*)

Contact Details 

Please use “00” to indicate the country code. Please do not use commas, dots or blank spaces between figures.
Office Phone No. (*)
Office Fax No.
Mobile No. (*)
Home Phone No.
E-mail (*)
ATTENTION! On this address, you will receive further notifications.