International Participant Registration Form
EAN Regional Teaching Course (RTC), Türkiye
Full Name (as in passport)
*
Date of Birth
*
Gender
*
Select...
Female
Male
Other
Nationality
*
Country of Residence
*
Passport Number (optional)
Affiliation (Institution/Hospital/University)
*
Department
*
Current Professional Role / Academic Title
*
Select...
Neurology Resident
Neurologist
Clinical Fellow
Assistant Professor
Associate Professor
Professor
Other (please specify)
Email Address
*
Phone Number (with country code)
*
Invitation letter required
*
Select...
Yes
No
Arrival date
*
Departure date
*
Dietary requirements / special needs
Additional comments
Submit Registration
Prof. Dr. Aslı Tuncer, on behalf of the Neuroimmunology Working Group,
Turkish Neurological Society, Chair, Neuroimmunology Working Group