Educational Grant - Application Form
Thank you very much for your interest in attending the CBL Plus, September 20-22 2026 in Freiburg, Germany
Title
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Please Select
Mr.
Mrs.
Dr.
Prof.
Prof. Dr.
-
Name
*
First Name
Last Name
E-Mail
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Hospital or University
*
Department, Institute
EFN Number
Only for Germany based professionals, required to receive CME Credits
Aortic Association Membership Status
*
Member
Non-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.
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of
Profession
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Please Select
Cardiac Surgeon
Cardiologist
Cardiovascular Surgeon
Vascular Surgeon
Radiologist
Imaging / Echography Physician
Anaesthesiologist
Perfusionist
Student
Other Physician
Nurse and allied Health Care Professional
Radiology Technician
Scientific Employee
Clinical Researcher
Industry (incl. R&D)
Other
Years of Experience
*
Please Select
0 - 4 Years
5 - 9 Years
10 - 14 Years
15 - 19 Years
Over 20 Years
Ticket Selection
Registration
*
Full Pass - Sunday, Monday & Tuesday
1-Day Pass - Monday, 21.09.2026
1-Day Pass - Tuesday, 22.09.2026
Aortic Association Membership Dinner - Sunday 20.09.2026, 19:00 - 22:00
*
I would like to participate
I don't want to participate
How did you hear about this event?
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Newsletter
Referral
Google Search
LinkedIn
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X / Twitter
Online advertisement
Event / Trade Show
Personal Invitation
Flyer / Poster
Other
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