ACTOS 2023 - EDUCATIONAL GRANTConference participation* Participation Thursday - November 30 Conference dinner - November 30 Participation Friday - December 1 Hotel Victoria - Single room Wednesday Nov 29 - Single Room Thursday Nov 30 - Single Room Friday Dec 1 - Single Room Rate per night: € 290Hotel Victoria - Double room Wednesday Nov 29 - Double Room Thursday Nov 30 - Double Room Friday Dec 1 - Double Room Rate per night: € 310Total PERSONAL INFORMATIONFirst name* Last Name* Hospital or Institute* City* Country* Email* Mobile phone number* Dietary wishes (optional) BIG-number (Dutch participants) ThursdayDinnerFridayINVOICE DETAILSHospital or Company* Contact person / Department / PO number (optional) Address* Postal code & city* Country* Hotel Victoria - Single - Wednesday 29.11 Price: Hotel Victoria - Single - Thursday 30.11 Price: Hotel Victoria - Single - Friday 01.12 Price: Hotel Victoria - Double - Wednesday 29.11 Price: Hotel Victoria - Double - Thursday 30.11 Price: Hotel Victoria - Double - Friday 01.12 Price: CommentsThis field is for validation purposes and should be left unchanged.