Registration Form
National Symposium of Bariatric and Metabolic Surgery

 
Event Management: Mosaic Events 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@chirurgiemetabolica.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 National Symposium of Bariatric and Metabolic Surgery
  • Step 1
    PARTICIPANT
  • Step 2
    REGISTRATION FEE
  • Step 3
    LIABILITY & DATA PROTECTION
  • Step 4
    Payment Methods
  • Step 5
    Preview / Submit
 
PARTICIPANT

Personal Information 
Title 1


Title 2



First Name (*)
Last 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. (*)
E-mail (*)
ATTENTION! On this address, you will receive further notifications.