Email registration

MESM 2020 Submission Form - PRICES VALID TILL DECEMBER 10TH - AFTER DECEMBER 10TH ADD €25

Title

First Name

Surname

Affiliation

Occupation and/or Title

Address

Zipcode

City

Country

VAT Number

Telephone

Fax

E-mail

EUROSIS member number

Extra's

NOT APPLICABLE - Extra Conference Dinner Ticket - (October 22) for companion €60

NOT APPLICABLE - Extra Conference Lunch Ticket - for companion €25/day

NOT APPLICABLE - Extra Conference Visit Ticket

NOT APPLICABLE - Extra Conference Proceedings - €40

NOT APPLICABLE - I am a vegetarian

NOT APPLICABLE - I prefer hallal food

Payment method

I will pay by CREDIT CARD and fill in the information below. ALWAYS CHECK YOUR CREDITCARD NUMBER AMD EXPIRY DATE BEFORE HITTING SUBMIT

Type of card

Card number

Cardholder name

Expiration date

Verification code

Email Registration NOT YET ACTIVATED