Online Registration Form

*Name	*Tax ID No.
*First Surname	*Second Surname
*email
Address	*Town/City
Postcode	Province
Contact number	Work number
	*Workplace

Contact Details (email) email You will receive the confirmation and invoice at this email address *

Invoicing Details

Name/Company Name (Name of the person the invoice will be sent to)	Tax ID No.
Address	Town/City
Postcode	Province
Phone	Send invoice to the attention of:

Accommodation Rates

Prices include breakfast and VAT

If you require accommodation please contact the Technical Secretariat

AESEC session Are you interested in the AESEC session?

Yes No

Dietary requirements / intolerances / allergies

Yes No

If you are submitting a communication based on a doctoral thesis, please indicate here the title of the communication and the name of the responsible author.

Yes, I am presenting a paper based on a doctoral thesis. No

A fun activity is planned for Friday, June 20th, in Madrid de los Austrias, from 7:30 to 9:00 p.m. Would you be interested in attending?

Yes No

Totals Total Registration Fee in Euros Euros Nights

Accommodation in Euros Euros Total Price in Euros Euros

Registration Cancellation Policy

The cancellation of registrations will lead to the withholding of the amount paid, according to the following schedule:

Before May 12th (inclusive), 25% of the fee will be withheld and the remainder refunded once the conference has ended.
Between May 12th and June 12th (both inclusive), 50% of the fee will be withheld and the remainder refunded once the conference has ended.
After June 12th, 100% of the fee will be withheld.

I've read and I accept Legal Notice and Privacy Policy exposed.

We inform you that during the workshop/conference there is the possibility of making videos or photographs that are later published on www.aes.es, as well as on our twitter profile and YouTube channel.

	Until April 21st included	After April 21st
AES members, new AES members	350 €	400 €
Associate members*	350 €	400 €
Societat Catalana de Gestió Sanitària members(SCGS)	350 €	400 €
Non-AES members	450 €	510 €
Student** AES members	100 €	150 €
Student** associates*	100 €	150 €
Student** non-AES members	150 €	200 €

1 day registration – Wednesday June 18 ***	180 €	180 €
1 day registration – Thursday June 19 ***	180 €	180 €
1 day registration – Friday June 20 ***	150 €	150 €

Espahotel Plaza de España

Espahotel Gran Vía