Personal Information - IGTD INT - Nurses and Technicians Advances in Invasive Physiology and Intravascular Imaging

Course registration

Title

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* First name

* Last name

* Email address

* Country of practiceThis question is required.

Country of practiceThis question is required.

* Mobile number

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What type of practice do you primarily work in?

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Hospital affiliation

Hospital postal address

Private practice name

Private practice postal address

Insert the email of the employer/hospital department that should be informed/notified about your participation to the education course.

* Employer/hospital email address

Do you have any dietary restrictions?

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Please specify:

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Vegetarian
Vegan
Pescatarian
Gluten-free
Lactose-free / Dairy-free
Halal
Kosher
Nut allergy
Other

Travel

Do you expect to travel to the course by:

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Visa invitation letter

Please note that the Philips IGTD International training and education team does not reimburse, manage, or submit visa applications. Participants are responsible for arranging and submitting their own visa applications.

If you, need a invitation letter, you can complete the information below and it will be provided to support your visa application process.

Do you require a Visa invitation letter?

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Given name (as per passport)

Surname (as per passport)

Nationality

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Passport number

Place of birth

Accommodation

The Philips IGT-D International Training and Education Team will arrange accommodation in accordance with the course schedule and the travel itinerary coordinated through our designated travel agencies.

Do you require accommodation?

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Any requirements for health and safety reason, specify below

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