The international (third all-ukrainian) congress on medical law, pharmaceutical law, bioethics and social policy icon

The international (third all-ukrainian) congress on medical law, pharmaceutical law, bioethics and social policy




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НазваThe international (third all-ukrainian) congress on medical law, pharmaceutical law, bioethics and social policy
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THE INTERNATIONAL (THIRD ALL-UKRAINIAN) CONGRESS

ON MEDICAL LAW, PHARMACEUTICAL LAW, BIOETHICS AND SOCIAL POLICY

Kyiv, 19-21 April, 2012


THE PARTICIPANT REGISTRATION FORM




Surname




Name




Affiliation




Position




Address




Telephone




Fax




E-mail







Report Title:









I would like to:

- participate at the Congress q;

- participate at the Congress and submit the abstract q;

- participate at the Congress, submit the abstract and make an oral presentation q;

- participate at the Congress, submit the abstract and make a poster presentation q.


I will need the following equipment for the presentation:

- a slide projector q;

- a multimedia q:

- a white-board q:

- a flip-chart q.


I would like to take part in the social program (reception, tours around Kyiv and Ukraine) suggested by the organizers:

- reception q;

- tour around Kyiv on April 21, 2011 q;

- special tour program on April 22, 2012 q.


I will need assistance in the hotel reservation:

- yes q __________ (please, specify the dates which you need the hotel reservation for):

single room q ; double room q.

- no q.


Your personal data will be kept confidential in accordance with the current legislation of Ukraine and will not be given to third persons for marketing purposes.


________________ ________________________

Date Signature

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