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Registration


This form is also available as MS Word-document

Personal Information

Title:  
First name:  
Surname:  
Department :  
Affiliation :
Hospital / University / Institute
Homepage Institute :
Adress :  
Post code:  
City:  
Country:  
Tel. no.:  
Fax no.:  
Email:  

Attendance please check the required fields Late registration
(after 1 February 2003)
Full Congress Members
(EFOMP, ESTRO, NVKF)
Non members
Retired/students *)
€ 400
€ 425
€ 150
2 days, dates
Day 1 :
Day 2 :		 Members
(EFOMP, ESTRO, NVKF)
Non members
Retired/students *)
€ 350
€ 375
€ 130
1 day, date
Day 1 :		 Members
(EFOMP, ESTRO, NVKF)
Non members
Retired/students *)
€ 275
€ 300
€ 110
extra program items:
partner No scientific sessions nor published abstracts € 75
participants Maastricht: Caves and City € 68
participants Thorn: White Town and Music € 47
participants Biesbosch: Birds and Coves € 58
participants Amsterdam: City and Space €395
participants The Hague: Royalty and Sea €295
Workshops tuesday 20 may
 Evaluation of coronary stenosis severity in the catheterisation room, theory and practice
New developments in imaging techniques in radiotherapy, Educational aspects
European Medical Physics School: PACS in practice today, the real facts
Standardized information: HL7/Dicom/Corba
€ 100
  Total €
*) students have tot send a letter of their Qualified Medical Physicist in which their status is confirmed.

Social events

Event Self Partner
welcome reception, tuesday, 20 may 2003
congress diner, thursday, 22 may 2003

Payment Details


Total amount due: €
(registration after 1 february 2003)

Direct Payment
I enclose a cheque made payable to EFOMP 2003 for the total amount due
Payment by (inter-)national bank transfer
international:
Account name: EFOMP 2003
International bank account number (Iban): nl 13 snsb 0873 527 798
Swift code SNS bank Eindhoven, the Netherlands: SNSBNL 2 A
national:
account nr. 873 527 798, SNS Bank, 18 Septemberplein 23, 5611 AL Eindhoven
tnv Stg. Klinische Fysica, EFOMP2003 TU/e facN, M.C.Groenendijk
Visa Card(please print this form and send it signed by fax/conventional post)
Master Card (please print this form and send it signed by fax/conventional post)

Please print this form and fill in the box below.

Card No.: ........ Card validation Code II **) : .......
Cardholder Name : ....... Exp. date : .......
Signature : ....... Date : .......
**) Card validation Code II is a three-digit number printed on the back of your credit card following your printed credit card number.

Conditions for cancellation of booking:
  • Cancellations made up to 20 April 2003 will be subject to an administration fee of €30. Refunding of the Total-€ 30.
  • Cancellations made between 20 April and 10 May 2003 will be refunded for 50%. Refunding of 0.5xTotal-€ 30.
  • Cancellations made after 10 May 2003 can not result in a refunding of 0.5xTotal-€30 unless your reservation can be resold.

    • Session Attendance
    Please check below which topics you are planning tot attend. This will help us with an appropriate room allocation

    Wednesday, 21 May 2003
    9.00-10.30 Opening Ceremony and EFOMP Medal 2001 Lecture
    11.00-12.30 Radiotherapy
    Imaging
    Lasers
    Ethics in medical physics
    14.00-15.30 Radiotherapy
    Lasers
    Imaging
    Computer Aided Diagnose
    16.00-17.30 Radiotherapy
    Lasers
    Imaging
    Safety and Risk management

    Thursday, 22 May 2003
    9.00-10.30 Plenary session: invited speakers
    11.00-12.30 Radiotherapy
    Brain, senses and movement
    Radiation Protection
    physiological modelling
    14.00-15.30 Audiology
    Medical Informatics
    Radiation Protection
    Education and Training

    Friday, 23 May 2003
    9.00-10.30 Plenary session and Young Investigators Award
    11.00-12.30 Audiology
    Functional Brain Imaging
    Radiotherapy
    Medical Informatics
    14.00-15.30 Radiotherapy
    Medical technology assessment
    Imaging
    Myocardial viability
    16.00-17.30 radiotherapy
    Imaging
    vascular stenoses quantification
    clinical informatics
    17.30-18.00 Best Poster Price and Closing Ceremony




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