Name *

According to your passport

First Name

Last Name

Date of birth *

MM

DD

YYYY

Expiration date passport *

MM

DD

YYYY

Degree *

Consultant surgeon (1375 EUR)

Chef de Clinique (1375 EUR)

Fellow (1375 EUR)

Resident in training (AIOS) (1225 EUR)

Resident not in training (ANIOS) (1125 EUR))

Researcher (1125 EUR)

Student (1125 EUR)

Do you want a single room? *

Yes (+150 EUR)

No