REGISTRATION


All fields require an entry.

name :  
occupation :  
address :  
email :  
phone / mobile :  

REGISTRATION
Before October 12: 50,00 euros
From October 13 to November 8: 80,00 euros
Students: 30,00 euros*
* Students must send a copy of the student card attached to this registration form.

Please note that the places are limited and the opportunity will be given on the first come first served basis.

PAYMENT METHOD
check (payble to "Associação Mulheres em Acção", sent to Av. da Boavista, 1015, 6º, s.606, 4100-128 Porto, Portugal)

bank transfer Bank Millennium BCP
IBAN CODE: PT50 - 0033 - 0000 - 45248482983 - 05
SWIFT/BIC: BCOMPTPL

Please note:
A copy of the banking transfer shall be sent to fax number (00 351) 226 094 027 at ASSOCIAÇÃO MULHERES EM ACÇÃO or to the following e-mail: info@lisbonmedicalconference.net

For booking reservations, please contact the following travel agency:
GEOTUR - Mr. Pedro Alexandre
Phone: (00 351) 218 422 736 Fax: (00 351) 218 422 739
e-mail: pedro.alexandre@geotur.com