Registration for international speakers

SA Formular ausländische Referierende

Persönliche Angaben

Acad. Title

First Name*

Name*

E-mail address*

Mobile*

Teilnahme

Entire Congress, 6 & 7 Nov. (free of charge)

Thursday, 6 Nov. (free of charge)

Friday, 7 Nov. (free of charge)

Saturday, 8 Nov.*

No participation

Swiss Anaesthesia Trainees' Day (free of charge)

"EEG for Anaesthesiologists – A workshop" (free of charge)

Hotel

I do not need a hotel room

Please book a room for me (2 nights as a guest):

Date of arrival (indicate only if hotel room is required)

Date of departure (indicate only if hotel room is required)

Veranstaltung(en)

Congress party, Musée Olympique, Friday 7 Nov.*

I will not participate

I will participate (meat/ fish)

I will participate (vegetarian)

I will participate (vegan)

Intolerances

Bankangaben für Reisespesen (Economy Flug, Zugbillet 1. Kl.)

IBAN or account details

Account holder (name & full address)

Zustimmung zur Veröffentlichung der Präsentation

I agree that my presentation will be published in a protected domain on www.swissanaesthesia.ch

I do not agree that my presentation will be published

I do not agree that my presentation is published but I will send a summary of my presentation in PDF to adrian.koenig@bbscongress.ch after the congress.

Bemerkungen