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Personal data

Title

First Name *

Family Name *

Date of Birth *

Place of Birth *

Country *

Fiscal Code (Only for Italians) *

E-mail *

Confirm your e-mail *

Professional data

Institute *

Institute Address *

Institute City *

Postal code *

Mobile Phone *

Registration

Category
In presence - Physician	free of charge
In presence - Resident/Student	free of charge
In presence - Medical Engineer	free of charge
On Line – Physician	free of charge
On Line – Resident/Student	free of charge
On Line – Medical Engineer	free of charge

Registration type *

ISHNE Member *

ISE Member *

Interested in participating in Young Investigator Award? *

Early career researcher under 35 years may be eligible for the Young Investigator Award competition.
If you wish to participate, please submit your abstract at this link and refer to the full set of rules at https://electrocardiology.org/yic/yic-rules.html

Dietary requirements/Food allergies *

Privacy policy

In accordance with General Data Protection Regulation UE 2016/679 we declare that the holder of data processing is Achelois Srl. Please take more information about personal data processing by accessing the site www.achelois.eu

AUTHORIZATION TO DATA MANAGEMENT FOR THE EVENT

I authorize Achelois srl to handle my personal data for purposes strictly connected to the present and future registrations. Achelois srl declares that this data will not be divulged or delivered to third parties, that are not strictly involved in the event management. IMPORTANT: by denying this authorization, registration to the event will not be allowed.

AUTHORIZATION TO DATA MANAGEMENT FOR THE EVENT *

AUTHORIZATION TO DATA MANAGEMENT FOR OTHER PURPOSES

I authorize Achelois srl to handle my personal data for marketing purposes (events announcements, newsletters and information on other events organized by Achelois srl and/or other Event Providers). Achelois srl declares that this data will be not be given to other subjects, that are not strictly involved in the Event organization.

AUTHORIZATION TO DATA MANAGEMENT FOR OTHER PURPOSES

Information

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For more information and assistance:

Acheloís - Professional Congress Organiser
Via Larga 8 - 20122 Milano
+39 02 500630 3032
@ info@achelois.eu
https://www.achelois.eu/