This meeting is held within the framework of Continuing Medical Education.
THE NUMBER OF PARTICIPANTS IS LIMITED applications will be accepted according to date of registration
(1 registration per participant)

I want to register to the 2nd International Headache Summit / Tel Aviv / November 4-8, 2010

Title:
Last name*:   First name*:
Specialty*:   Institution:
Address 1*:
Address 2:
City*: Zip*: Country*:
Phone:   Fax:
E-mail*:

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REGISTRATION FEES

- Before 15/06/2010: 350 $ per delegate (250 €)

- After 15/06/2010: 400 $ per delegate (300 €)

- Israeli Doctors registration : 400 shekels

For further information, please contact

Laetitia Parienti - 01 72 33 91 01 - contact@headache-summit.com
REGIMEDIA - 326, Bureaux de la Colline - 92213 SAINT-CLOUD CEDEX - FRANCE
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