. Name *Surname *Email *Profession *Institute *Zipcode and city *Phonenumber *Member of scientific association (NVKC/CMI/arts/etc)BIG/NVKC numberAre you a NVC memberYesNoI want to be a member Registration Day 1 11 March (€ 160,00) Registration Day 2 12 March (€ 80,00) Registration both Days 11-12 March (€ 240,00) Bedrag * € Betaalmethode * iDEAL Bancontact Belfius Pay Button (+ 1%) Hierbij geef ik toestemming om het terugkerende bedrag periodiek van mijn rekening te incasseren. Totaal € Send form
