EMRI | ERASMUS COURSE ON MAGNETIC RESONANCE IMAGING

MRI OF THE BREAST AND FEMALE IMAGING, WROCLAW, POLAND, 4-6 JUNE '09

I want to register for the MRI of the Breast and Female imaging module, Wroclaw, Poland, 4-6 June 2009:

name
first name
institution
department
address
zip
city
country
telephone
fax
email

FEE: Registration fee, including course materials: 500 € full fee, reduced to 200 € for residents (certified by the head of the department, please fax this document to 0032-2-477.53.62). Early registration fee before April 1st: 400 €, residents 160 €.

Your bank cheque or money order should be payable to:
account nr.: 375-1007077-05
(ING, Marnixlaan 24,1000 Brussel)

IBAN: BE96375100707705
Swift-address: BBRUBEBB

Please mention: "44501204 + your name