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Home >> Login >> Personal details
     
Personal details    
(*): required field

 
*Title and Family name
 
 
 
*First name
 
 
 
Organisation
 
 
 
Department
 
 
 
*Address
 
 
 
*Postal code
 
 
 
*City
 
 
 
*Country
 
 
 
*E-mail address
 
 
 
Telephone
 
 
 
*Fax
 
 
 
Fiscal code (Italians only)
 
 

 
My E-mail address is
 
 
 
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*Type it again password
 
 


 
I will take part in ANR 2004 as:
 
 
A participant
     
  An accompanying person to:  
  No, I will not take part in ANR 2004 but I need hotel reservation.  
 
I intend to participate into the following workshop(s)
if registering as a participant:
 
 
“Microarray technology” (June 16, 2004)
 
  “Spinal cord compression” (June 19, 2004).  
  “Opsoclonus Myoclonus” (June 19, 2004)  
 
Profession or primary field of research
if registering as a participant:
 
 
 
 
Special requirements
(e.g. dietary, medical, wheelchair access, etc.):
 
 
 

 
I will get to Genoa by:
 
 
 
*Arrival date (dd/mm)
 
 
 
*Departure date (dd/mm)
 
 


     
Need help? Send an e-mail to anr2004@neuroblastoma.org