Registration form
This form must be filled and forwarded to Millennium Congress (by fax, email or surface mail)
Personal data
Surname Name
Born on at
Job title / area of interest Affiliation / Company Home address
Zip Code City
State
Tel Fax Cell Phone
Email address
I wish to register to
Before September 10 After September 10❍ l Pre congress course € 300 € 350
select only one option
❍ Ultrasound guidance and EKG-guidance for central venous access in English
❍ l PICC DAY € 200 € 250
❍ l GAVeCeLT Congress € 250 € 300
❍ l l PICC DAY + GAVeCeLT Congress € 350 € 450
Payment
❍ I enclose copy of bank transfer
To the order of: Millennium Congress - divisione di Scuola Nuova srl Banca Popolare dell’Emilia Romagna - Agenzia Via Flaminia 241 IBAN IT44T0538703209000001992559
BIC/SWIFT BPMOIT22XXX
Personal data will be handled with maximal confidentiality, according to the Italian law 675/96 about privacy. They will not be disclosed to third parties and will be cancelled any time if requested.
date signature
Congress
Secretariat
Millennium Congress
Viale del Vignola 3d 00196 Roma T + 39 06 3221854 F + 39 06 3221853 www.scuolanuova.it millenniumcongress@scuolanuova.it In collaboration with
CCI Centro Congressi Internazionali
Via San Francesco da Paola 37 10123 Torino T + 39 011 2446917 - 26 [email protected] [email protected]
l Pre-Congress
Courses
Theoretic-practical courses
for physicians and nurses
December 4th
l
7th PICC Day
International meeting
focused on PICCs
and Midline catheters
December 5th
l
7th GAVeCeLT
Congress
The present and the future
of venous access devices,
between patient’s safety and
cost-effectiveness
December 6-7
Centro Congressi
Lingotto Torino
December 4-7
GAVeCeLT
Gli Accessi Venosi Centrali a Lungo Termine
Event organized in collaboration with
