Registration Form To register for the 30th European Symposium on Urogenital Radiology, please fill in the fields below and press send. Fields marked with an asterisk (*) are compulsory. The data provided will be used to prepare the attendees documentation. For group registrations contact the Organising Secretariat by clicking hereIndicate if the invoice will go to… (when you select an option the bulletin will be shown) If you wish to receive an invoice with the attendee name, click here If you wish to receive an invoice with the company or institution name, click here PERSONAL DATA Name* Surname* ID/VAT NUMBER/PASSPORT/OTHER* Address* City* Postal Code* Country* Telephone* Email* Please check if your e-mail address is correct. It will be used to send you your registration notification. Workplace REGISTRATION FEES Registration Fees Early Bird Fee(until June 3rd) Middle Fee(until July 17th) Late Fee(until September 16th) ESUR Faculty Member 250 € 250 € 250 € Member 495 € 525 € 555 € Non member 585 € 635 € 665 € ESUR Junior/Resident Member 235 € 315 € 345 € Junior/Resident Non Member 315 € 345 € 375 € Radiographer 235 € 315 € 345 € Medical StudentIt will be compulsory to prove Resident status by sending a document from your boss or tutor by e-mail to info@lisbon2024.esur.org 150 € 200 € 250 € Plese select the option to apply the VAT: NO VAT Companies, Foundation and Public Entity based within the EU.Companies based in the Canary Islands, Ceuta and Melilla.Companies not based in EU countries. 21% VAT Companies based in Spain (Península y Baleares) 23% VAT (VAT Portugal) None of the above. MEALS MEALS Amount Members’ dinner – Thursday, 19 September (Zambeze Restaurant) 65 € Gala dinner – Saturday, 21 September (Monte Mar Lisboa) 96 € Juniors’ dinner – Friday 20 September (SOHO Restaurant) 35 € Please, write here if there is any special consideration: vegetarian, allergy, gluten free… HOTEL ACCOMMODATION HOTEL Double Single Use Double ALTIS GRAND HOTEL 5* (Congress’ Venue) FULL 240 € 260 € Eurostars Lisboa Parque 4* FULL 235 € 250 € Iberostar Selection Lisboa 5* FULL 245 € 265 € Exe Liberdade 3* 210 € 225 € Pestana Lisboa Vintage 4* FULL 190 € 200 € Check in: – select – 18/09/2024 19/09/2024 Check out: – select – 22/09/2024 23/09/2024 Rates per night. Bed & Breakfast. TOURIST TAX HOTEL DRSU DOUBLE ALTIS GRAND HOTEL 5* (Congress’ Venue) 2 € 4 € Eurostars Lisboa Parque 4* 2 € 4 € Iberostar Selection Lisboa 5* 2 € 4 € Exe Liberdade 3* 2 € 4 € Pestana Lisboa Vintage 4* 2 € 4 € Exempt from VAT. Taxes per night and person. Payment method* Bank transfer (ES83 2100 8880 8113 0055 9540 SWIFT: CAIXESBBXXX) Credit card (VISA o MasterCard) COMMENTS Please fill in the data to process the invoice. Fiscal name* ID/VAT NUMBER/PASSPORT/OTHER* Address* City* Postal Code* Country* Telephone Email* Contact Person* Comments Once we received payment confirmation, we will send you an invoice with the registration form name. Once we received payment confirmation, we will send you an invoice with the registration form name. IMPORTANT INFORMATION Please find below full details of payment and cancellation policies. – General terms and conditions: https://lisbon2024.esur.org/purchase-conditions/ – Privacy policy: https://lisbon2024.esur.org/privacy-policy/ To contact us: Phone:+34 960728212 Email: info@lisbon2024.esur.org I have read and accept the conditions set out above. I have read and accept the policies set out above. Contact us Organising Secretariat info@lisbon2024.esur.org +34 960 72 82 12 Name Email Message 8 + 9 = Enviar
