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 Sept 30 After Sept 30❍ l Pre congress course € 250 € 300
select only one option
❍ Ultrasound guidance and EKG-guidance for central venous access
in English
❍ Ponctions veineuses centrales et périphériques sous échographie
en Français
❍ Venipunción central y periférica eco guiada
en Español
❍ l PICC DAY € 150 € 200
❍ l Congresso GAVeCeLT € 200 € 250
❍ l l PICC DAY + GAVeCeLT Congress € 300 € 400
Payment
❍ I enclose copy of bank transfer
To the order of: Millennium Congress - divisione di Scuola Nuova srl
Unicredit Banca di Roma - Ag. 2010 - Piazza Gentile da Fabriano 11
C/C 0000081043/52 - IBAN IT 76 O 03002 05020 000008104352
ABI 03002 - CAB 05020
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.
data firma
Congress
Secretariat
The Secretariat of the 2nd PICC DAY and of the 7th GAVeCeLT Congress will be managed by
Millennium Congress
Viale del Vignola 3d 00196 Rome
T +39 06 3221854 F + 39 063221853
www.scuolanuova.it
millenniumcongress@scuolanuova.it
For information about hotel accomodation close to the Congress venue, please write to Manuela Tartagni c/o Millennium
Congress m.tartagni@scuolanuova.it
l
Pre-Congress
Courses
Theoretic-practical courses
for physicians and nurses
November 30th
l
5th PICC Day
International meeting
focused on PICCs
and Midline catheters
December 1st
l
7th GAVeCeLT
Congress
Targeting zero: how to
minimize the complications
associated to the insertion
and maintenance of venous
access devices
December 2nd – 3rd
Catholic
University
November 30
December 1-3
GAVeCeLT
Gli Accessi Venosi Centrali a Lungo Termine
Event organized in collaboration with
