CORSI BLSD, PBLSD, PRIMO SOCCORSO AZIENDALE

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MODULO ISCRIZIONE CORSI PRIMO SOCCORSO

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Nome e Cognome* This field is required.
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Comune di Nascita
Provincia di Nascita
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Data di nascita * This field is required.
Giorno
Mese
Anno
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CODICE FISCALE* This field is required.
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Indirizzo di residenza* This field is required.
Indirizzo e numero civico
Indirizzo Riga 2
Città
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Afghanistan
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CELLULARE* This field is required.
Prefisso
Numero di Telefono
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PROFESSIONE* This field is required.
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E-mail* This field is required.
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Data e Luogo dei corsi in programma* This field is required.
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Crediti Ecm in FAD su richiesta per sanitari iscritti ad un albo/ordine
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Seleziona
20 Crediti Ecm (costo aggiuntivo 50€)
15 Crediti Ecm (costo aggiuntivo 40€)
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* This field is required.
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TAGLIA POLO ISTRUTTORE
TAGLIA XS
TAGLIA S
TAGLIA M
TAGLIA L
TAGLIA XL
TAGLIA XXL
TAGLIA XXXL
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