ACTOS 23 - FACULTY CONFIRMATION FORMConfirmation I will join the faculty and attend both conference days I will join the faculty on Thursday November 30 only I will join the faculty on Friday December 1 only First name*Last name*Hospital / Institute*City*Country*Email* Mobile phone number* Profile photo*Max. bestandsgrootte: 512 MB.Please upload a profile photo - Minimum 400 x 400 pixelsPhoneDit veld is bedoeld voor validatiedoeleinden en moet niet worden gewijzigd.
