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INDIVIDUAL REGISTRATION FORM
In order to be informed about SECEBT 2021 news, please fill in correctly the contact information bellow.

Attention! All the form fields are mandatory.

FIRST NAME
LAST NAME
CUIM for physicians (CUIM is available only for registered members of The Romanian College of Physicians).
The certificates of attendance for physicians that are not members of CMR will not have CME points.


I WILL ATTEND THE MEETING AS:



SERVICES
Conference Registration *
Registration fee

PERSONAL CONTACT INFORMATION
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E-mail
Phone
INSTITUTION INFORMATION
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Address
City
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Country
Phone
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