PresidentRaffaele PuglieseDirector of Niguarda Hospital Surgical Department
Honorary PresidentMichael Bailey (United Kingdom)
VenueAula Magna Niguarda HospitalPiazza Ospedale Maggiore, 3 – 20162 Milano
ECM credits requested
2009
10Th Meeting on Techniques and Technology:
LIVE VIDEO-ASSISTEDDIGESTIVE SURGERY
Milan, 4-5 June 2009PRELIMINARY PROGRAM
Registration form
The participation to the Conference is possible after fi lling and returning this form and it is open to the fi rst 270 applicants. The Meeting is free of charge for 50 employees of A.O. Niguarda Ca’ Granda.
Registration fee: Euro 400,00 + VAT 20%
Ways of payment: Bank cheque not transferable addressed to: ILCAM Bank transfer on c/c n. 35908 addressed to: ILCAMBanca Regionale Europea Ag. 39 Niguarda, MilanoABI 06906 - CAB 01798 - Cod. CIN N - Swift cod. BLOPIT22IBAN IT68N0690601798000000035908(cause: MEETING - ILCAM June 2009)
The registration form and payment order have to be sent to the Organizing Secretariat by fax (+39 02.6444.2905) before May 24th, 2009
Surname
Name
Professional Qualifi cation
Subject
C.F./ VAT:
Born in Date of the birth
Address
Country Zip Code
Phone Mobile Phone
Fax
The information above is essential for the administration of the formative event, and it will be managed in accordance with the D.Lgs n. 196/2003.By signing the form you allow the use of your personal informations according to Law 675/96.
Date Signature
Address the bill to:
Address:
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