Registration Form

Please fill the form below to register to the 6th ME Cardiopace.

You can also download this PDF Version.


PERSONAL DATA (Please use capital letters)



REGISTRATION FEES


Speakers & Chairpersons : (Waived)Active participants - After March 1st or on site : 600 US$Active participants - Before March 1st : 450 US$Lebanese Residents - University Students : (Waived - Except lunches)Foreigner Residents - University Students : 100 US$Abstract Presenter Participants : 250 US$Lebanese doctors practicing in Lebanon : 100.000 LBP

Additional badge for exhibitors : 200 US$


PAIMENT METHOD


Bank ChequeBank Transfer

- Bank Cheque to be made to M.E.-Cardiopace / Charles JAZRA)
- Transfer to be made (Without charges to the receiver) to M.E.-Cardiopace C. Jazra - IBL BANK Bauchrieh Branch - Lebanon - IBAN LB4800520030023010003215033 / SWIFT INLELBBE Via The Bank of New York, 1, Wall Street, New York NY, 10015 USA - A/C Number USD 8033215046.