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PRIJAVNI FORMULAR
XXII KONGRES UDRUŽENJA INTERNISTA SRBIJE
Surname:
*
Name:
*
Institution:
*
Institution address:
*
E-mail:
*
ID licence LKS:
*
Mandatory fields!
REGISTRATION FEE - for doctors
150
KOTIZACIJA_150: DA
REGISTRATION FEE - for representatives of the pharmaceutical industry
60
KOTIZACIJA_60: DA
ACCOMMODATION - per person based on 3 half board (buffet) and BTO.
HOTEL
Single Room
Double Room
Double superior
FONTANA ****
370
FONTANASNG11: DA
267
FONTANADBL12: DA
319
FONTANAAPT: DA
ZEPTER ****
301
ZEPTERSNG11: DA
232
ZAPTERDBL12: DA
PEGAZ ****
224
PEGAZSNG11: DA
181
PEGAZDBL12: DA
double room with:
The number of single rooms is limited and will be filled in the order of payment.
TRANSPORTATION - There will be no organized transportation. Transportation by arrangement for groups.
CANCELLATION - Cancellation of accommodation – according to the General Terms of the Agency.
MODE OF PAYMENT - BANK ACCOUNT
LICNO PLACANJE: DA
Personal
PLACA USTANOVA: DA
Institution
PLACA SPONZOR: DA
Sponsor
Name
PIB
Address:
E-mail or Faks
IMPORTANT NOTE! All prices are in EUR. After receipt of the registration form, the executive organizer will send the proforma invoice with deadline for payment. The executive organizer retains the right to make changes of terms and prices in case of changes of transportation fares, disorders on the monetary market and unpredictable circumstances.
Deadline to send Registration form is June 1, 2023.
Saglasan sam sa uslovima ucesca na skupu i sa Opstim uslovima putovanja agencije
*
I agree with the terms of participation to the Congress.
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