* 1. Personal information about the trainee

* 2. Last obtained (relevant) degree (e.g. MSc, BSc, PhD, MD)

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* 3. Are you already a specialist in CM, ID, IC/HH or Public health

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* 4. Please indicate which payment option you choose

* 5. Do you have dietary restrictions? If so, please specify below

Please ensure all required data is entered correctly: it will not be possible to modify your information afterwards.

Upon pressing the submit button, your registration form will be evaluated for its completeness and we will send you the bank details for payment (this may take a day or two).

Your registration will only be complete once you have paid the amount as indicated above.

After receipt of the registration fee, you will receive a confirmation of payment and registration.


In case you experience any difficulties with this form please contact nancy.gerits@escmid.org

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