EASIM 2023 Bratislava Application

An application link for the 5th European Advanced School of Internal Medicine in Bratislava 2023

Course dates: 3 – 5 November 2023 (Friday to Sunday)

Venue: Park Inn by Radisson Danube Hotel, Bratislava, Slovakia

Target audience: up to 15-20 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: 550 Euros per person (Early Bird, 600 Euros Regular) which will include the following - course costs, accommodation in Park Inn by Radisson Danube Hotel for 2 nights (3-5 November 2023), all meals, school facilities, etc. (650-700 Euros if extra night required, double rooms also available per request).

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

Webpage: www.easim2023.eu
Please, complete and submit the application link for EASIM 2023 as soon as possible by Monday, 18th September 2023, 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: