Please complete this online form to register for either or both components of the ESPNIC / EPIC Dubai event this November: The ESPNIC Autumn School on 6 and 7 November 2017 and/or the EPIC Diploma exam administration on 8 November 2017. 

Questions about the event may be directed to epic@espnic-online.org or +41 22 560 7401. One of our Credentialing Department team members will respond to your message within three business days. 

Once your purchase is processed, one of our Credentialing Department team members will send you a registration confirmation, along with logistical details.

* 1. Customer's Contact Information

The registration fee for the two-day (6 and 7 November 2017) ESPNIC Autumn School is EUR 366 (approximately AED 1,582) for ESPNIC Members / EUR 495 (approximately AED 2,139) for nonmembers--including lunch and coffee breaks on both days.

If you register for both the two-day ESPNIC Autumn School and to take the EPIC Diploma exam on 8 November, we will discount your Autumn School registration fee by EUR 100!

For just the Mechanical Ventilation component (one day, 7 November) of the ESPNIC Autumn School, the registration fee is EUR 257 for ESPNIC Members (approx. AED 1,108) / EUR 347 for nonmembers (approx. AED 1,496). There is no discount available for registering for one-day-only plus the exam.

If you are not an ESPNIC Member on the date you submit this form, you will be charged the nonmember rate; to take advantage of the ESPNIC Member rate, please purchase an ESPNIC membership first, at http://espnic-online.org/Membership/Medical-Doctors; once your member application has been confirmed, come back to this form and complete your purchase.

The applicant guide (including eligibility requirements, exam topical content outline, and authoritative references), exam fees, and hyperlink to the application form for the EPIC Diploma are at http://espnic-online.org/EPIC

Whether or not you have already submitted your EPIC Diploma application, please let us know on this form if you would like to take the exam on 8 November 2017 in Dubai; if you have not yet submitted your EPIC Diploma application, please do so by 13 October, so we can analyze your eligibility and confirm your registration for the exam administration on 8 November.

Hotel sleeping rooms are EUR 179 (approximately AED 775) per night, at a 5-star hotel in the heart of Dubai--including taxes and breakfast! Please indicate on this form on which nights you are reserving a sleeping room; if you do not reside in Dubai, please make your hotel sleeping room arrangements through this form, so that we can meet our room block commitments with the meeting venue.

The agenda for the Workshop starts at 08:00 and ends at 18:00 on 6 November and 7 November; on 8 November, the EPIC Diploma exam Part 1 is from 09:30 - 12:00, and Part 2 is from 14:00 - 16:30. Please make your hotel sleeping room reservations on this form (and travel arrangements) accordingly. 

By submitting this form, you are authorizing us to charge your credit card for the applicable fees as of the date you submit this form, based on your answer to the question on this form.

Please note that the Autumn School registration fee, EPIC Diploma exam fee, and hotel sleeping room fees are non-refundable under any circumstances, due to our financial commitment to the meeting venue. You are encouraged to ask us questions (via email to epic@espnic-online.org or telephone at +41 22 560 7401) before submitting this form if you are unsure whether you want to make a purchase at this time.

* 2. Please enter your credit card information below.

* 3. Are you currently an ESPNIC Member? (This will be verified)

* 4. Please select your ESPNIC / EPIC Dubai event registration and reservation choices (select all that apply):

That's it! Once you click "Done," we will process your purchase.  Thank you for your dedication to the specialty and to the competent, ethical, and professional care of criticall ill children!

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