Participant

Personal Data

*Required field

Participant Type*

Member VDAEPC (Doctors in Private Practice & Heads of Department)
VDAEPC Fellows
VDAEPC Juniors
Non-member
Member DGPRAEC / DGAEPC
Speaker
Exhibitor

Gender*

Degree

First Name*

Last Name*

Please enter your billing address below - Thank you!

Address

*Required field

Company

Department

Street*

Postal Code*

City*

Country*

Communication

*Required field

Phone Number*

Email*

You will receive the booking confirmation as well as the invoice via E-Mail.

Dietary Preferences & Allergies/Intolerances

*Required field

Dietary Preferences*

vegetarian

vegan

allergies & intolerances

No restrictions

Please specify your allergies and intolerances in detail: