Registration

Please don’t forget to proceed to payments (bottom of page) after filling out the registration form.

Name*

E-mail*

Institution

Please check all that apply
MD, PhD studentPhD studentDermatologistMD, other specialtyResearcherTechnicianOther

BIG registration number (if applicable)

Reservation of hotelroom*
noroom with 1 bedroom with 2 beds (indicate roommate below)

Lunch/dinner*
NoneLunch day 1Dinner day 1Lunch day 2VegetarianOther (please specify below)

Payment will be made by Department/as a group
Grouppayment (check if TRUE)


Please proceed to iDeal payments below (please state your name in the payment when using a commercial bank account eg. BV account).

(Academic registration fee applies for academic appointments >0.5 fte)

 

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