Please read the online registration instructions before completing the form - thank you!


EQALM Symposium 2008 Registration
  Title:
  Forename:
  Surname:
  Job Title:
  Telephone:
  Fax:
  email (please check!!):
  Department:
  Organisation:
  Street address:
  Town/City:
  District/region:
  Country:
  Postal code:
  Dietary requirements:
  Affiliation:  I am a member of EQALM
 My organisation is a member of EQALM
 I am on the Executive Board
 I am an invited speaker
 I am a Working group Convenor
 none of these apply
  Working Group attendance (2 only):  haematology blood smears
 Haematology cell counting
 Haemostasis
 Nomenclature
 Microbiology
 ISO 17043 mirror
 Virtual Microscopy
 not attending working groups
  Date of arrival:
  Date of departure:
  Hotel:
  Names of accompanying persons:
  Number of additional Dinner places (€50 each):
  I agree to register and pay the fee:  YES
 NO
  Payment options: