REGISTRATION FORM
for the Live Injections Course,
ADVANCED FACIAL CONTOURING – 2014
(October 26, St.Petersburg, Russia),
part of the Second Live Surgery & Injections Course,
ADVANCED AESTHETIC RHINOPLASTY, OTOPLASTY, AND FACIAL CONTOURING – 2014 (October 24-26)
Please fill in this form, email it to pk@aasurgery.ru, and we will get back to you with the payment details.
Full name of the attendee
Employer
Registration option
Gala dinner, October 25!
(Please choose the relevant option
and delete the rest.)
E-mail
Telephone
ZIP code
Country
City, region
Street address
Cosmetology only (October 26) - 12,000 rubles
3,000 rubles
YES
NO
Please fill in this form, email it to pk@aasurgery.ru, and we will get back to you with the payment details.