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COMPLEMENT-RELATED KIDNEY DISEASES

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COMPLEMENT-RELATED KIDNEY DISEASES

COMPLEMENT-RELATED KIDNEY DISEASES

SURNAME

NAME

E-MAIL (personal)

PHONE NR

STATUS

specialist fellow student other

PAYER

I am the payer the payer is the institution exempt from registration fee

PAYER - institution or name and surname of the payer

PAYER - liable to pay tax

YES NO

PAYER - identification number for VAT

OTHER

CONSENSUS

By submitting my application, I confirm that I consent to the collection of data for educational purposes in accordance with the GDPR.

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