Congress Registration

 

Surname  *
Name  *
Affiliation  *
Address  *
Postal Code *
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City  *
Country  *
Phone *
+39
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    E-mail *
    Social Insurance Number (Codice fiscale)
    VAT Number (Partita IVA)


    Declaration (Autocertificazione)*
    Medical Doctor
    Pharmacist
    Medical Student


    Only for medical students: upload a photo of your "Student Medical ID badge"
    Drag & Drop Files Here Browse Files


    Only for Italians (Solo per italiani)

    PEC (obbligatoria se non si ha il codice ID Destinatario)
    Codice ID Destinatario


    Notes (Note) 


    Registration fees (Quote d'iscrizione)*
    ICMART Members
    Non Members
    Medical Student


    Currently it's not possible to participate in the Gala Dinner because it's sold out. If there is the possibility and you are interested in participating  contact us at icmart2022@gmail.com


    Total
    € 0.00
    Privacy *

    Privacy policy

    Complete the registration(completa la registrazione)

    AMAB