Registration Form - RHINA 2019

21 - 23 March 2019, Eastbourne, United Kingdom


Personal Data

Please use Title Case when filling in the form (i.e. Smith).
Please use English Alphabet only (do not use special international characters).

First Name
 Middle Name
Last Name
Year of birth (yyyy)
Address
Postal code
City or State
Phone Number (include Country Code)
Mobile Phone Number (include Country Code)
E-Mail
Re-confirm E-Mail


*If you are an EAACI member and you change any personal data above (e.g. your address), please note that this will be updated automatically in your EAACI membership profile.


Professional Details

Your answers to the following questions will help us in preparing scientific programmes for future events.


Do you have a license to prescribe medicine:


Letter of Invitation

Please click below if you require a letter of invitation for visa purposes.

Please note that the Letter of Invitation will be sent to you after EAACI has received your full payment for the meeting registration. EAACI may ask you to provide additional documents (Passport copy, Contact details of the institution you work for, etc.) before issuing the Letter of Invitation.


Registration Fees (Early Bird registration)

Please choose your registration category (If you are an EAACI Member you will be able to choose your registration category after entering your Member Number and Password at the beginning of this registration).



EAACI will provide a Pocket Programme to each delegate.


Payment of Registration Fee
IMPORTANT

Please note that we only accept Credit Card payments.

It is possible to pay by Visa or Mastercard. You may be asked by the issuer of your card to enter a password to verify that the transaction is authorised by the card owner before completion of the payment process (3-D Secure technology).

I agree to the Terms and Conditions:




Total Ammount (EUR):


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