BSONT – Group Registration Form

Belgian Society for Ophthalmic Nurses and Technicians

ACCESS ONLY ON FRIDAY November 29, 2024
BSONT – Group Registration Form – 2024
EARLY REGISTRATION DEADLINE – November 6, 2024
REGISTRATION FEES are indicated on the website
PARTICIPANTS

IMPORTANT we need a UNIQUE email PER PARTICIPANT, if not we return this registration form to you!
Name Participant 1

First NameLast Name
Email Participant 1
example@example.com
Name Participant 2

First NameLast Name
Email Participant 2
example@example.com
Name Participant 3

First NameLast Name
Email Participant 3
example@example.com
Name Participant 4

First NameLast Name
Email Participant 4
example@example.com
Name Participant 5

First NameLast Name
Email Participant 5
example@example.com
Name Participant 6

First NameLast Name
Email Participant 6
example@example.com
Name Participant 7

First NameLast Name
Email Participant 7
example@example.com
Name Participant 8

First NameLast Name
Email Participant 8
example@example.com
Name Participant 9

First NameLast Name
Email Participant 9
example@example.com
Name Participant 10

First NameLast Name
Email Participant 10
example@example.com
Name Participant 11

First NameLast Name
Email Participant 11
example@example.com
Name Participant 12

First NameLast Name
Email Participant 12
example@example.com
INVOICE ADDRESS
Hospital*
Contact persons name*
Email address of contact person for this list*
example@example.com
Invoice Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
VAT *
IMPORTANT Please fill in VAT no. if you are a tax payer, if not you can fill in "na" not applicable.
CANCELLATION AND REFUNDS:

Refunds up to 75% of the advanced registration fee will be granted for cancellations received in writing (email christy@ophthalmologia.be) prior to November 6, 2024. Refunds will not be granted for later cancellation or no-shows.
Should be Empty:

BSONT – Group Registration Form – 2024

PARTICIPANTS

INVOICE ADDRESS