REGISTRATION Section ÉvénementTitreevents_atoutcomSpécialitéEvtOrganisateurAdresseEvtVilleEvtCodePostalEvtPaysEvtDateDebutDateFinTVASection participantLast Name*First Name*Professional E-mail* Profession*EstablishmentAddress*Ex : 10 Rue Albert EinsteinAdditional addressEx : Building, Company, Floor...Zip Code*City*Country*Professional Phone*Je suis pris en charge par mon service de formationOuiNon Early Bird Registration Rates - Until March 26, 2023Doctor : 450 €Assistant : 300 €Pack Doctor and assistant : 600 €Junior Doctors & Clinic Directors* : 300 €SOFCEP Members* : 400 €*with supporting documentSOFCEP JUNIOR Members : contact us at nicetox-course@atoutcom.com to benefit from the preferential ratesAssistant's Information First Name Last Name Assistant's establishmentAssistant's e-mail Assistant's Phone ANATOMICAL DISSECTION & INJECTION WORKSHOP Thursday, May 11th 2023*Doctor : 800 €I don't want to participate CONGRESS DINNERFriday, May 12th 2023*I want to participate - 120€I don't want to participate Total 0,00 € Payment MethodBank transferCheckPayment by credit card (1.75% Bank charges)Check are accepted only for France
