Auspices Application Form - Rev. 3

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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: [email protected] - cc [email protected]
C-ET - EFLM auspices application form - Rev. 3 January 2016 (effective until further revision)
1/1
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