pdf La sentenza della Corte costituzionale n. 37/2015

Courses
“ Color-Doppler of extra and intracranial vessels “
Naples, March 27, 2015
“ Advances in Cardiovascular MRI”
Naples, March 29, 2015
Please fill in and send by fax /e-mail to Organizing Secretariat MP s.r.l. Congressi e Comunicazione
Tel +39 081/5753432 Fax +39 081/5750145 – e-mail :[email protected] – web site : www.mpcongress.it
PARTICIPANT
______________________________________________________________________________________________________
Family Name
First Name
______________________________________________________________________________________________________
Address
______________________________________________________________________________________________________
Post Code
City
Country
______________________________________________________________________________________________________
Mobile
Ph./Fax.
Please fill in ( complete in block capitals) and return to: MP s.r.l. Congressi e Comunicazione Via Coroglio, 57/D – 80124 Napoli
Ph. +39 081 5753432 - +39 081 2466459 fax +39 081 5750145 e-mail: [email protected] – web site : www.mpcongress.it
______________________________________________________________________________________________________
e-mail
______________________________________________________________________________________________________
Fiscal Code o VAT Num.
Date of birth
Place of birth
REGISTRATION FEES (in Euro) Please note that registration fees include VAT 22%
registrations w ill be accepted until February 10, 2015
M arch 27 ULTR ASOUND COUR SE ECM
Medical Doctor
€ 150,00
In training doctor (student)
€ 75,00
Members of other affiliated Scientific Societies
( ISNVD, SIRM, SIUMB,SIAPAV)
€ 100,00
Provider MP S.R.L. ID 1263 . The event has been accredited CME from the Ministry of Health No. 50 participants :
Medico chirurgo discipline: Angiologia,Cardiologia; Geriatria;Medicina Interna;Chirurgia Vascolare;
Neurochirurgia;Anatomia Patologica; Neurofisiopatologia;Radiodiagnostica;Neuroradiologia;Medicina Generale
Gala Dinner March 28
€ 80,00
29 M ARZO MR I COUR SE ECM
Medical Doctor
€ 75,00
In training doctor (student)
€ 50,00
Members of other affiliated Scientific Societies
( ISNVD, SIRM, SIUMB,SIAPAV)
€ 75,00
Provider MP S.R.L. ID 1263 . The event has been accredited CME from the Ministry of Health No. 100 participants:
Medico chirurgo discipline: Angiologia,Cardiologia; Geriatria;Medicina Interna;Chirurgia Vascolare;
Neurochirurgia;Anatomia Patologica; Neurofisiopatologia; Radiodiagnostica;Neuroradiologia;Medicina Generale
PAYMENTS
ALL PAYMENTS MUST BE MADE IN EURO AND ADDRESSED TO
the registered person”
MP S.R.L. AND MARKED WITH THE CODE “EVENT ……….+ name and surname of
Credit Card / Please charge the sum of Euro _______________ + transit commission bank € 9,00
from
Visa
Master Card
Carta Si
Card Number n._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date
/
/
Number of security __ __ __ * Corresponds to the last 3 digits of the identification number on the back of the card
Cardholder_____________________________________________________________________________________________
Signature___________________________ Date ______________________________________________________________
Bank Transfer / (net of bank charges) Euro ______________________________________________________
Account holder: “MP srl Congressi e Comunicazione” Bank: Banca Popolare dell’Emilia Romagna – Napoli
Account n. 211837 Abi code: 05387 Cab code : 03411 Cin D
IBAN code : IT33D0538703411000000211837– SWIFT code: BPMOIT22XXX
Certification of payment made by bank transfer m ust be mailed or faxed w ith t he registration form.
INVOICING (please fill only in case invoice should be named and addressed to another subject)
Family Name ______________________________________ First Name _________________________________________
Address____________________________________________________City ________________________________________
Country ________________________Post Code_______ Fiscal Code o VAT Num_____________________________________
Date___________________________ Signature ________________________________________
In accordance with Legislative Decree 196/03 I authorize the use of data provided for the purpose of receiving information and notices.

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