ONLINE REGISTRATION FORM
Please fill the registration form with your details. Fields marked with (*) are mandatory.
You must complete the application form, even if you are exempt from the registration fee.
Name and Surname / Ime in priimek: *
Academic Title / Akademski naziv: *
Home Address / Domači naslov: *
Employer, Institution / Zaposlitev, ustanova: *
Department / Oddelek: *
Phone or Mobile / Telefon ali GSM: *
E-mail Address / Elektronski naslov: *
Gala Dinner, Friday / Gala večerja, petek: * I Will attend Gala Dinner / Večerje se bom udeležil(a)I will not attend Gala Dinner / Večerje se ne bom udeležil(a)
Category / Kategorija: * Members of SZD, EUSUHM, IAAH / Člani SZD, EUSUHM, IAAHNon-members / NečlaniResidents / SpecializantiPensioners, Students / Upokojenci, študentiAccompanying Person / SpremljevalecIndustry / Predstavnik industrije
Profession / Poklic: * Physician / ZdravnikNurse, Midwife / Medicinska sestraPharmacist / FarmacevtStudent / ŠtudentOther / Drugo
Congress Attendance / Udeležba na kongresu: * Full Attendance / Polna udeležbaDaily Attendance (Thursday) / Dnevna udeležba (četrtek)Daily Attendance (Friday) / Dnevna udeležba (petek)Daily Attendance (Saturday) / Dnevna udeležba (sobota)
Payer's Name / Plačnik kotizacije:
Payer's Address / Naslov plačnika:
ZIP code and City / Poštna številka in kraj:
VAT ID / Davčna številka:
Data controller guarantees that the data will only be used for the purpose for which it was collected. Upravljalec osebnih podatkov zagotavlja, da se bodo podatki uporabljali le za namen za katerega so zbrani.
By submitting this form, you acknowledge that you have read, understood the Registration Terms and agree to all its terms and conditions. Z oddajo prijavnice potrjujete, da ste prebrali in razumeli Pogoje prijave ter se strinjate z vsemi njihovimi določili.
If you do not receive a confirmation email within 2 hours, please contact us at tajnistvo-zzp@szd.si. Če v 2 urah ne prejmete potrditvenega e-sporočila, nas kontaktirajte na tajnistvo-zzp@szd.si.
Registration is not active yet! / Prijave še niso omogočene!