Form Wizard

Registration

Step 1

Total including registration: 0

Paid Options:

Title*

First Name*

Last Name*

Gender

Date of Birth*

Phone Number (With Country Code)*

E-mail*

Confirm E-mail*

Emails do not match.

Country*

Country of Practice*

Status*

Speciality (If Medical Doctor)*

AFRAN Member*

Yes (Join Proof)

STNDT Member*

Yes (Join Proof)

Pre-Congress Courses

Yes, I want to attend Pre-Congress Courses

Gala Dinner

Yes, I want to attend the Gala Dinner

Payment method* Please note: Additional transfer fees are the responsibility of the submitter, and a percentage surcharge will be applied.

Institution*

Department

Address*

Postal Code*

City*

Country*

Arrival Date

Arrival Airport

Departure Date

Departure Airport

I Accept Terms and Conditions

I Accept Cancellation Policy

Download Invitation Letter