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@metabolicsurgery.ro

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

The Organizers thank you in advance for providing your detailed coordinates enhancing the communication related to the
National Symposium of Bariatric and Metabolic Surgery.
  • Step 1
    PARTICIPANT
  • Step 2
    REGISTRATION FEES
  • Step 3
    LIABILITY & DATA PROTECTION
  • Step 4
    Payment Methods
  • Step 5
    Preview / Submit
 
PARTICIPANT
The sections marked with * are mandatory.
Title 1 (*)

Title 2 (*)





First Name (*)
Last Name (*)
CNP (*)
Afilliation (Hospital / Organisation / Institution) (*)
Department / Specialty (*)
Head of Department/Clinic (*)

Professional Address 
Street., No., Bl., Ap. (*)
Postal code (*)
City and County / Disctrict (*)
Country (*)

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