Advanced Course on Regenerative Medicine - REMED

Registrations are closed.

In case you have difficulties in completing the application form please contact us via email: margarida.filipe@ipleiria.pt / mauro.sousa@ipleiria.pt


Fields marked with * are mandatory

1. Personal Information

(Please insert your full name according to your identification card.)
(Please insert your email address. The address introduced will be used for future communications)

2. Invoice Information

Please fill in the fields below if you require the invoice in a different name from above-mentioned.


3. Registration - Conference fees

Price
TOTAL: 0.00 €

4. Payment Method


Morada IPLeiria:

Instituto Polit�cnico de Leiria

Rua General Norton de Matos

Apartado 4133

2411-901 Leiria

Portugal


Política de Privacidade | Política de Reembolso


Note: After you select the credit card payment method and submit the application form, you will receive an email for credit card payment instructions.



ATM payment only available for participants with Portuguese national bank account





5. Submit Registration

I declare that all informations provided on this Application Form are true without any omission to the same. *