Registration Form - Allergy School on Insect Venom Allergy and Mastocytosis

11 - 13 April 2019, Groningen, The Netherlands


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
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 into your EAACI membership profile.


Professional Details

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


Certificate of Attendance and CME Certificate

The CME letter can be downloaded after completing the survey which will be sent to the registered e-mail address after the school. If the registration has been made with a different email address you shall make sure that the delegate will receive the certificates. Or you shall inform to the EAACI Headquarters, events@eaaci.org, about the delegate’s email address in order to send the certificates directly to the relevant person.


Letter of Invitation

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

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


Accommodation

I would like to share the room with
(if you have no preference, room allocation will be done by EAACI Headquarters)

Accommodation opt-out

I do not wish to use the shared twin room accommodation included in the registration package and will take care of my own accommodation booking and payment.



If you select the accommodation opt-out version, the amount of EUR 80.00 will be deducted from your registration fee. Please note, that if you have selected this option, EAACI will not be responsible for the booking or payment of your accommodation.

Should you change your mind and require shared accommodation after registration, EAACI will be glad to help, however we cannot guarantee availability. Kindly note that more than one time accommodation change will be charged a EUR 50.00 administration fee.

The registration package includes accommodation in a shared twin room (2 nights, from 11-13 April 2019) (if you select the accommodation opt-out version, NO accommodation will be booked for you) and meals during the Allergy School. For any additional nights or individual bookings, please click here. For any other questions regarding your accommodation, please contact EAACI Headquarters.


Dietary Requirements

Please indicate below if you have any special Dietary Requirements (Vegetarian, etc.).
Dietary Requirements

Registration Fees

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).


Payment of Registration Fee
Please note that if you are an EAACI Member, your membership must be fully paid up in order to benefit from the reduced registration fee.
If you have not paid your EAACI membership fee for this year yet, please login to the Members Area on www.eaaci.org.

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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