Auspices of the European Federation of Clinical Chemistry and Laboratory Medicine Application Form Contact Details Organising Society or Group: Contact Person: (title, first name and surname and address) e-mail: Detail of the event requesting EFLM auspices Name of the event: Proposed date and place: Specific goals of the event: No of expected participants: Event website: Application I apply for EFLM auspices for the above event. I agree to the terms of the EFLM guidelines and confirm that this event will allow free circulation of scientists. I have attached details of: the scientific/educational programme the date and the venue the organizing secretariat address Date Signature Please send this application to: Prof. Ralf Lichtinghagen EFLM Chair of the Education and Training Committee (C-ET) e-mail: Lichtinghagen.Ralf@mh-hannover.de - cc silvia.cattaneo@eflm.eu C-ET - EFLM auspices application form - Rev. 3 January 2016 (effective until further revision) 1/1