1st Monographic Course Secpre 2018
REGISTRATION Home Presentation Committees Faculty Hotels Programme Exhibit Information Venue Abstracts
REGISTRATION Home Presentation Committees Faculty Hotels Programme Exhibit Information Venue Abstracts

1st Monographic Course Secpre 2018

Registration Form

PERSONAL DATA *Mandatory data
*Surname: *Name:
Department: Hospital / Institute:
*Address: *Zip code:
*City: *Country:
*Telephone: Fax:
*E-mail: *ID or Passport:
REGISTRATION FEES *Mandatory data
REGISTRATION FEE Until 1/03/2018 From 2/03/2018
SECPRE MEMBERS   550 €   700 € 
OTHER SURGEONS   950 €   1.050 €
SECPRE RESIDENTS *   375 €   500 €
OTHER RESIDENTS *   525 €   600 €

21% VAT included

The registration fee includes: documentation, attendance to the scientific sessions, coffee, lunches and official Dinners.

Deadline for registration is 26th May, 2018. After that date, both registration and payment will be made at the Course Venue.

(*) Resident doctors shall enclose a certificate signed by the Head of the Service. Participants not submitting the certificate will pay registration fee as SECPRE Member or as Other Surgeons.

Cancellation Policy:
• Changes and cancellations must be notified in writing to the Congress secretariat.
• Refunds will be made once the Course is over.
• Cancellations until 1/3/18 - Refund of 80%.
• Cancellations from 2/3/18 until 5/26/18 - Return of 50%.
• There will be no refund for cancellations after 5/27/18


TOTAL REGISTRATION FEE: Rellenar el formulario anterior.
PAYMENT METHOD *Mandatory data
  Transfer      Credit card

Payments must be made in Euros to:

Fundación Docente SECPRE
CAIXABANK
C/ Clara del Rey, 31-33
28002 Madrid

Bank account: 2100 3918 82 0200191604
IBAN (electronic format): ES1621003918820200191604
IBAN (print format): IBAN ES16 2100 3918 8202 0019 1604
SWIFT / BIC: CAIXESBBXXX

(Please enclose copy of payment with your registration form)

Please send copy of payment to fax no. + 34 91 571 92 06 or enclose a file (JPG, GIF or Word format) by clicking in "Payment receipt

Remarks: Residents shall include a certificate signed by the Head of the Service.

  Payment receipt:   
PLEASE, FILL IN FOR INVOICE PURPOSES
  Individual   Company
*Last Name: *First Name:
*Passport number: *Address for invoice:
YOU WISH TO BOOK ACCOMMODATION?
  Yes          No
Information and Conditions for accommodation booking.  See clause
I have read and accept the legal clause.   See clause.

IMPORTANT: After pressing "SUBMIT", please wait a few minutes without pressing any other key, and without closing the page, until the "Successful Submission" message appears or go to the payment gateway to complete the registration if you have chosen "Payment by card".
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