NATIONAL FACULTY GRANTFaculty Dinner (pre-conference) Faculty dinner - Wednesday September 20 Conference participation Conference program - Thursday September 21 Conference dinner - Thursday September 21 Conference program - Friday September 22 Hotel - Single Room Single Room - Wednesday September 20 Single Room - Thursday September 21 Hotel - Double Room Double Room - Wednesday September 20 Double Room - Thursday September 21 PERSONAL INFORMATIONName* First Last Hospital or Institute*This info will appear on your personal name tagCity*CountryEmail* Mobile phone number (with country code)*Dietary wishes (optional)NameDit veld is bedoeld voor validatiedoeleinden en moet niet worden gewijzigd.