Name:    First Name:  

Position title:     

Institution:     

Address1:     

Address2:     

ZIP, City:                    

Country:           

Work phone: 

Personal phone:  

E-mail:   

Registration fee:

Ordinary fee non FINE members:
350 € before 30th July
400 € after 30th July

FINE members: 300 €
Nursing students (undergraduate): 150 €

Fee includes Welcome meeting, coffee, tea, 2 lunches

Fee does not include Gala Dinner: 20 €

Total:
Conference:   €uros

Gala Dinner: €uros

Payable to by bank transfer on account: Instituto Gestão Crédito Público
                                                           Conta: ESEL-FINE LISBON-2010
                                                           NIB:   0781 0112 00000007912 03

                                                           IBAN: PT50 0781 0112 00000007912 03

                                                           BIC:   IGCPPTPL