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Personal data

Gender:
Title:
Surname *:
First name *:
 
Institute/Affiliation:
Audiological Society represented:
Street *:
ZIP-Code *:
City *:
Country *:
Phone *:
eMail *:
Mobile:
Fax:
* required

Accommodation Altera Hotel deadline 31.07.2020
Alexander Hotel deadline 03.08.2020
City Club Hotel deadline 01.06.2020
Best Western Heide Hotel deadline 20.08.2020
Hotel Wieting deadline 24.08.2020
Hotel Sprenz deadline 01.08.2020
no Hotel
other
hotel name (if other hotel):
 
 
I will attend the meeting from (date and time):
to (approx.):
Note: Meeting dates: September 25th, 9hrs until September 26, 14 hrs
 
special meals requests:
Further information



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