REGISTRATION FORM
Third Live Surgery & Injections Course
ADVANCED AESTHETIC RHINOPLASTY, OTOPLASTY AND FACIAL CONTOURING. 2015
(23, 24, 25 October, St. Petersburg)
Name of the Course participant
Place of work
The registration type
(erase unnecessary options)
Days of participate
(erase unnecessary options)
Application for a Gala dinner on
October 24
For participants: 690 Euros
For members of ISAPS: 650 Euros
For interns and graduate students: 400 Euros
Exhibition
Guest
All days (October 23,24,25)
The first day (23 October)
The second day (October 24)
The third day (October 25)
70 Euros
Yes
No
E-mail
Contact telephone
Postcode
Country
City
Address
The COST of PARTICIPATION IN ONE DAY of COURSE - 400 Euros
Completed registration form should be sent to pk@aasurgery.ru . After entering the information into the
database of participants of the Course You will receive a confirmation e-mail.