REGISTRATION FORM

Title*

Name*

Firstname

Surname

NAME BADGE INFORMATION WILL INCLUDE NAME AND LAST NAME EXACTLY AS ENTERED IN THE REGISTRATION FORM.

Gender*

Email*

ATTENTION! PLEASE USE THE SAME EMAIL ADRESS FOR REGISTRATION PAYMENT PROCESS

DEMOGRAPHICS
Fields with an asterisk (*) are required.

How did you hear about ECI*

Highest Level of Education *

Field of Study *

What is your institutional setting? *

What is your occupation / job title? *

Are you a member of a national EFIS member society? *

What is the name of the national EFIS member society you are a member of?

In order to take advange of member or student registration fees, please upload a written confirmation of your member status signed by your national societies or a copy of your Student ID or a written confirmation of your status as technician/research nurse signed by your institution or the head of department.