1. Please enter your details in the form below:

  2. Choose your registration options.
  3. Click 'Proceed to Secure Payment'
  4. Please print and send or Fax Registration Form to             Euro-Med Congress for Radiographers, P.O Box 30, Paola, PLA1000, Malta, or Fax: +44 20 7483 5083
  5. We will contact you via email to confirm payment

    Note: * indicates a required field
 
COMPANY NAME:  
NAME:*  
SURNAME:*  
     
ADDRESS:*

eg.                    17, Old Road, Headington, Oxford,  OX39DT,  UK
TELEPHONE:*  
EMAIL:*  

Item Description

 Price Insert quantity
Full member €75 per year

Student Member €60 per year

   

 
Sub Total:

Euros
Credit Card Charges at 3.5%

Euros
Amount

Euros