ACTOS 2024 - FACULTY CONFIRMATION FORM
Confirmation
I will join the faculty and attend both conference days
I will join the faculty on Thursday November 28 only
I will join the faculty on Friday November 29 only
First name
*
Last name
*
Hospital / Institute
*
City
*
Country
*
Email
*
Mobile phone number
*
Profile photo
*
Max. file size: 512 MB.
Please upload a profile photo - Minimum 400 x 400 pixels
Phone
This field is for validation purposes and should be left unchanged.
