YERUN Research Workshop - Health and Ageing

PERSONAL DATA

Data protection agreement (required)
Your agreement is required in order to process your registration. Your contact details are held in a secure manner for the purposes of YERUN Research Workshop - Health and Ageing.

Please indicate YES to proceed with your registration*

ACCOMMODATION
For accommodation at Hotel SANA Executive please CLICK HERE

* Mandatory fields

Name *

Email *

I agree to the information on this form being stored in an electronic format by Abreu Events and used for the purposes of Workshop: Health and Ageing - Digital Health, New Technologies administration. *

Other. Please specify

If you selected "Other" in the question "University", please specify.

QUESTIONS

University *

Position *

Phone number *

Main interests
and motivations

Will you attend dinner on June 17th? *

Dietary Restrictions

Other dietary restriction

If you selected "Other" in the question "Dietary Restrictions", please specify.

Payment

Value

Bank transfer

The bank transfer must be made to the account number mentioned below, free of charge to the recipient:

Bank Address: Banco BPI
Rua Tenente Valadim, 284
4100-476 Porto, Portugal

Payee: VIAGENS ABREU, SA
VAT Number: 500 297 177

Bank Account: 6-1292463.000.001
IBAN: PT50 0010 0000 1292 4630 0013 1
Swift/BIC: BBPIPTPL

Credit Card

Card Number

Name

Expires on

Code (the last 3 digits on the back of the credit card)

Credit Card Issued in USA / Canada / Australia
(You will be contacted with the details for the payment within the next 48h)

Comments

REGISTRATION FORM

REGISTRATION CLOSE

PERSONAL DATA

QUESTIONS

Services Summary

Payment