Registration Form for Congress 2023.

NOTE TO ALL PARTICIPANTS: By completing and submitting the Registration Form, you are officially registered to participate in the Congress.
The registration fee for members of associations SESIAM, ZEM, CUDEL, and SRBSAPS is 350 EUR. (The gala dinner is included in the price.).
The early registration fee until August 15, 2023, for non-members of the associations, for doctors and dentists, is 500 EUR (Gala dinner is not included in the price).
The registration fee after August 15, 2023, for non-members of the associations, for doctors and dentists, is 600 EUR (Gala dinner is not included in the price).
The price of the VIP Gala Dinner is 100 EUR.

Title
First name
Last name
Status: Doctor / Dentist
Position: Institution / Private Practice
Address
Mobile phone
Postal code
City
State
E-mail
License number
Are you a member of SESIAM, ZEM, CUDEL, or SRBSAPS association?
Congress registration fee:
VIP PARTY
TOTAL


Payment instructions for international transfers

Payment purpose: SESIAM 2023

Recipient: SESIAM udruženje, Vojvode Stepe 319, Beograd

Payment account: 0070800048042

IBAN RS35205007080004804241

Commercial Bank, Serbia

BANK SWIFT: KOBBRSBG