New registartion

Title* Title*Dr.Prof.Mr.Mrs.Ms.Assoc. Prof.

Name Surname*

Country*

City*

Phone number*

Email*

Are you member of BNSAVS?* Are you member of BNSAVS?*YesNo

Workplace type* Workplace type*HospitalPrivate practiceUniversityUniversity HospitalOther

Name of the organisation*

Would you like to enjoy a lunch buffet following the welcome drink on 19th April?* Would you like to enjoy a lunch buffet following the welcome drink on 19th April?*YesNo

Would you like to enjoy a diner buffet on 19th April?* Would you like to enjoy a diner buffet on 19th April?*YesNo

Please fill in your invoice details in case you wish to receive an invoice. If you do not want an invoice, leave the field blank.