Personal Information
*
Name
Middle Name
*
Surname
*
e-Mail
*
ID number / Passaport number
*
Mobile Phone
*
Hospital / Institution
*
Department
*
Invoice Address
*
Country
*
City
*
Registration Type
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Nurse
Junior Member (under the age of 35 years)
Junior non-Member (under the age of 35 years)
Member (EPC and IAP)
Non Member
National Junior Participant (under the age of 35)
National Participant (above the age of 35)
EPC Honorary Member
Postgraduate Courses Registration
Do you want to register for the course?
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Yes
No
Events Registration
Do you want to register for the event(s)?
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Yes
No
Payment Information
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Payment Type
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Bank Transfer
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Registration Fee
€
Course(s) Fee
€
Event(s) Fee
€
Total Fee
€
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