National Insurance Number/Personal ID (optional field)

Last Name*

First Name*

Email*

International country code and Mobile phone (es. +39 3347596431)*

Country/Region*

City*

Degree*

Specialization*

Place and date of birth* (ie. City dd/mm/yyyy)

CME Credits* YESNO

Billing Address

Full Name* (First name and Last Name)

VAT number (optional field)

Address* (Street, City and Postal/Zip Code)

Address Line 2 (optional field)

Note:

Registration fee: € 100,00 (Vat included) include:

· Admission to the scientific sessions

· Congress bag with complete meeting materials
· Certificate of attendance

· Access to the exhibition area


Terms of payment


Bank Name: Banca Carige Italia

Branch/Bank address: Via del Pigneto 12 - 00176 Roma (RM)

Account Name: MORE COMUNICAZIONE S.r.l

Account Number: 000000617680

IBAN: IT81N0617503273000000617680

Swift or BIC: CRGEITGG

Payment description: please include your full name and “Frontiers of Radiosurgery”.
Please, send payment copy by e-mail at amministrazione@morecomunicazione.it

Privacy

All data released will be collected and processed - in manual and IT mode - in compliance with RGDP 679/2016 for the eventual sending of informative material related to this conference. The data will be disclosed to externale subjects, with the exception of banks, correspondence companies, companies appointed by us for the management of services, the scientific secretariat and/or the organizing committee of the conference.

I accept

To allow marketing activities about our events, Ecm events and medical courses about Neuroscience we thank to provide a separate consent.
It is your right to request the updating or cancellation of your data, or to oppose their use by writing to the responsible and data controller: MORE COMUNICAZIONE SRL, Via Cernaia 35, 00185 Rome, info@morecomunicazione.it