Registration Speakers at Satellite Meetings

SA Formular Refs SatMeet

Personal Data

Acad. Title

First Name

Name

E-mail address

Mobile

Participation

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 as SSAPM member (150 CHF)

Swiss Anaesthesia Trainees' Day as SSAPM non-member (200 CHF)

"EEG for Anaesthesiologists – A workshop" as SSAPM member (150 CHF)

"EEG for Anaesthesiologists – A workshop" as SSAPM non-member (200 CHF)

Accommodation

I do not need a hotel room

Please book a hotel room for me (1 night offered):

Arrival hotel (indicate only if hotel room is required)

Departure hotel (indicate only if hotel room is required)

Social Event(s)

Congress party, Musée Olympique, Friday 7 Nov.

No participation

I will participate (meat/ fish) (CHF 100)

I will participate (vegetarian) (CHF 100)

I will participate (vegan) (CHF 100)

Intolerances

Bank details for travel expenses

Speakers from Switzerland: 1st class train ticket, half-fare card
Speakers from abroad: Economy flight, 1st class train ticket

IBAN or Account details

Account holder (name and full address)

Consent to the publication of the presentation

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.

SwissAnaesthesia