EASIM 2022 Winter Application

An application link for the 4th European Advanced School of Internal Medicine (EASIM) in Riga 2022

Course dates: 26 – 28 November 2022 (Saturday to Monday)

Venue: Radisson Blu Rīdzene Hotel, Riga, Latvia

Target audience: up to 15 Internal Medicine (IM) specialists from European countries in the first 10 years after completion of postgraduate training in IM but also more experienced internists are welcome to participate.

Course fee package: 500 Euros per person which will include the following - course costs, accommodation in Radisson Blu Rīdzene Hotel for 2 nights (26-28 November 2022), all meals, school facilities, etc. (600 Euros if extra night required, double rooms also available per request).

Special price for local participants (without a hotel) - 300 Eur.

Webpage: https://easim2022.mozello.lv/
Please, complete and submit the application link for EASIM 2022 as soon as possible by Monday, 14th November 2022, or contact directly the organisers at internisti.lv@gmail.com

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* 1. NAME OF AN APPLICANT:

FAMILY NAME:

FIRST NAME:

MIDDLE NAME (if any):

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* 2. POSTAL ADDRESS AND COUNTRY:

Postal address:

Postal address (2nd line):

COUNTRY:

Do you need a visa invitation (Yes/No):

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* 3. Date of Birth:

Date:

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* 4. Gender (M/F):

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* 5. E-mail:

E-mail 1:

E-mail 2 (alternative) - optional, state N/A if the same:

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* 6. Mobile phone (including country code +XX-xxxx...):

Mobile phone:

Alternative phone - optional, state N/A if the same: