Aortic Master Class 2026 - EDU GRANT APPLICATION

Educational Grant - Application Form

Thank you very much for your interest in attending the Aortic Master Class. January 19th-20th 2026 in Cologne, Germany
Title*
Name*

First NameLast Name
E-Mail*
Hospital or University*
Department, Institute
EFN Number
Only for Germany based professionals, required to receive CME Credits
Aortic Association Membership Status*

MemberNon-Member
Please provide your Membership Number (7 digits) or Industry member name
If you don't have your membership number on hand, don't worry, we will check your eligibility for the member discount manually.
Upload CV

Cancelof
Profession*
Years of Experience*
Ticket Selection
Aortic Master Class Registration*

2-Day Pass - Monday & Tuesday1-Day Pass - Monday, 19.01.20261-Day Pass - Tuesday, 20.01.2026
Workshop - Sunday 18.01.2026, 14:00 - 18:00*

I would like to participateI don't want to participate
Aortic Association Membership Dinner - Sunday 18.01.2026, 18:00 - 20:00*

I would like to participateI don't want to participate
How did you hear about this event?*
Should be Empty:

Educational Grant - Application Form