A Q U A R I U S - S.r.l.

	-= Hemodyn 2011 - The Vasculab Conference - Napoli, October 13th-14th, 2011 - Hotel Terme di Agnano=-				VASCULAB The Vascular List
Hemodyn2011\|Abstracts\|Vasculab

-= HEMODYN 2011 =-

-= THE VASCULAB CONFERENCE =-

-= Napoli, October 13th-14th, 2011 - Hotel Terme di Agnano =-

The page's says that you are visitor number since Jun 18^th, 2011

The Meeting is reserved to Physicians, PhysioTherapists, Technicians and Nurses.

Subscription Form
Early Medium Late

until Jul 31st from Aug 1st to Sep 15th after Sep 15th

Mandatory fields are labeled with (*). If missing, it will not be possible to complete the subscription.

The subscription must be completed paying the required fee.





Title			Prof. 	Dr. 		Other  

(*) Name		
(*) Surname		
(*) born at			
(*) born on		  


(*) Address		
(*) Zip code.		
(*) Town		

(*) Country		

(*) Tel			

Fax			
(*) E-mail		
Mobile phone		
Institute

your data will be treated with the full protection of your rights and your privacy, according to the law
data are required only for organizing and archiving aims and to update you about our projects on the Meeting and the Course
your personal data are treated with electronic as well as papery formats.
data are required to subscribe to the Meeting and to the Course. If missing subscription isn't possible.
your authorization to the treatment of data includes also your acceptance of the above rules. Aquarius srl, Napoli, is responsible for the treatment of data.
Whenever you want, you can ask to update or to erase your personal data, mailing to Meeting Secretariat.

(*) I authorize the treatment of data - - - I don't authorize

(Without authorization it will not be possible to complete the subscription.)

The Hemodyn 2011 Meeting subscription fee (Oct 13/14) includes:

participation to the Meeting
Meeting kit
- bag
- didactic material
- the Hemodyn 2011 participation certificate
4 coffee breaks (Oct 13/14)
2 lunchs (Oct 13/14)

The MEVc Course subscription fee (Oct 11/12) includes:

participation to the Course
Course kit
- bag
- didactic material
- the MEVc Course participation certificate
4 coffee breaks (Oct 11/12)
2 lunchs (Oct 11/12)

Subscription fees don't include the Social Dinner, the Gala Dinner and all the social activities.

FEES

Subscription fee

Physicians
Amounts in Euro VAT included	Early until Jul 31st YES Vasculab	Medium from Aug 1st to Sep 15th YES Vasculab	Late after Sep 15th or NO Vasculab
Hemodyn2011	120	150	180
MEVc Course	450	500	550
Hemodyn2011 + MEVc Course	500	580	650

FKT / Technician / Nurse
Amounts in Euro VAT included	Early until Jul 31st YES Vasculab	Medium from Aug 1st to Sep 15th YES Vasculab	Late after Sep 15th or NO Vasculab
Hemodyn2011	80	100	120
MEVc Course	350	400	450
Hemodyn2011 + MEVc Course	390	450	520

PROFESSION

Physician
FKT
Technician
Nurse

(*) I ask to be subscribed to the MEETING
HEMODYN 2011. THE VASCULAB CONFERENCE (October 13-14th, 2011)
YES NO

(*) I ask to be subscribed to the COURSE
HEMODYNAMICS OF THE VENOUS MAP (October 11-12th, 2011)
YES NO

(*) VASCULAB SUBSCRIPTION is mandatory in order to get reduced fees.
I ask to be freely subscribed to the Vasculab List (no fee)
YES NO

Individual Options Summary
Vasculab	Profession	Fee
Subscribed Hemodyn 2011	Subscribed MEVc Course	Subscribed Hemodyn 2011 + MEVc Course

Subscription Fee

The subscription fee for the Accompanying person (Oct 13th-14th) includes:

2 tours (half day - morning)

The touristic trip covers the full day (Oct 15th).

Which social activity do you want to participate to ?
	Subscription Fee in Euro
Social Dinner Oct 13th	70
Gala Dinner Oct 14th	110
Touristic trip Oct 15th	55
Accompanying person Oct 13th-14th	80

Fee for social activities

Total fee

Totale Fee authomatic computation is under test. Check it manually and if a mismatch is found write to the Organizing Secretariat.
The mismatch isn't found if using Google Chrome ©

go to CREDIT CARD payment

go to BANK TRANSFER payment

The bank transfer must be effectuated in 5 days after sending the registration form.

For info contact

Hemodyn 2011 Organizing Secretariat

Email redazione@vasculab.it Web Page www.vasculab.it
tel/fax: +39 081 7144110 cell +39 3356250756

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