Confederation Individual Membership Application Form



You will receive an automatic confirmation e-mail upon completion of this form.
More information about the Confederation of European ORL-HNS can be found on the official website.

Data Protection:
A registration is not possible without collecting, saving and processing your personal data (required fields with *). This is done in accordance with the most recent legislation on data protection (EU-GDPR 2018) and solely for the purpose of organising and realising the event. Please use the following link to read the detailed data protection regulations and information obligation: CEORL-HNS data protection regulations.


PERSONAL INFORMATION




             
  
Company Information    
CEORL-HNS Executive Office
c/o Mondial Congress & Events
T +34.618 533 894
gloria.casanova@ceorl-hns.org 
Contact person: Gloria Casanova

  

MEMBER OF

 

Who should become a member:

- European ENT: Practicing or retired ENT that are members of a subspecialty and/or national member societies (European countries including Israel acknowledged by the United Nations) will full access to all Confederation benefits.

- International Members: Full member of a non-European ENT society.

- Other Professionals: All other ENT-related professionals as audiologists, speech therapists.


I am member of the following ORL-HNS Societies:




             
  
Company Information    
CEORL-HNS Executive Office
c/o Mondial Congress & Events
T +34.618 533 894
gloria.casanova@ceorl-hns.org 
Contact person: Gloria Casanova

  

Please select the topics from your interest:




             
  
Company Information    
CEORL-HNS Executive Office
c/o Mondial Congress & Events
T +34.618 533 894
gloria.casanova@ceorl-hns.org 
Contact person: Gloria Casanova

  

I WANT TO BECOME MEMBER OF THE CONFEDERATION:
50.00
50.00
50.00

             
  
Company Information    
CEORL-HNS Executive Office
c/o Mondial Congress & Events
T +34.618 533 894
gloria.casanova@ceorl-hns.org 
Contact person: Gloria Casanova

  

DECLARATION OF CONSENT


Processing of your data by the Confederation of European ORL-HNS
 
Your personal data (comprising name, contact data & address data), collected by Mondial Congress & Events, may be passed on to Confederation of European ORL-HNS and Young Confederation of European ORL-HNS. The named societies have permission to process your personal data and to contact you directly for the promotion of future and topic-related events, for the promotion and to disseminate information about activities of the society (eg: competitions, travel grants, etc.) and for the evaluation and further development of the current congress, as well as its future editions.
This declaration of consent can be retracted at any time by sending a written message to Mondial Congress & Events, Operngasse 20B, 1040 Wien or to dataprotection@mondial-congress.com 




             
  
Company Information    
CEORL-HNS Executive Office
c/o Mondial Congress & Events
T +34.618 533 894
gloria.casanova@ceorl-hns.org 
Contact person: Gloria Casanova

  

SUMMARY

In case your booking summary is correct, please click “next” to continue to the payment page.
Please click “Edit” to alter your data.

DATA PROTECTION REGULATIONS & CONDITIONS

You can find the data protection regulations here.



             
  
Company Information    
CEORL-HNS Executive Office
c/o Mondial Congress & Events
T +34.618 533 894
gloria.casanova@ceorl-hns.org 
Contact person: Gloria Casanova

  

PAYMENT


Option 1: By Bank Transfer
Bank: Unicredit Bank Austria AG
Account Holder: CEORL-HNS
IBAN AT94 12000 52946026849
SWIFT/BIC: BKAUATWWXXX
Please indicate your full name as reference on the bank transfer. Bank charges payable by the sender.
Note: Bank transfers from outside the Single Euro Payments Area (SEPA) must be "free of charge for the recipient". Any bank fees incurred will be charged to the sender
At the end of the process, when submitting the application, you will receive a confirmation email including the bank account information detailed above.


Option 2: Online Credit Card Payment
Visa, MasterCard, AMEX and Diners will be accepted.
Please enter your credit card details and click on "complete booking". The authorisation process will then take between 5 and 30 seconds.
During this time, please avoid clicking on the “back arrow”. This would interrupt the process, possibly resulting in double charges on the card.
As soon as the authorisation is confirmed, you will be transferred to the next page.



             
  
Company Information    
CEORL-HNS Executive Office
c/o Mondial Congress & Events
T +34.618 533 894
gloria.casanova@ceorl-hns.org 
Contact person: Gloria Casanova

  

THANK YOU

Thanks for your interest. You have successfully applied as Member of the Confederation of European Otorhinolaryngology – Head and Neck Surgery!

An automatic confirmation e-mail has been sent to your e-mail address.

The Confederation of European Otorhinolaryngology – Head and Neck Surgery


Young Confederation webpage

             
  
Company Information    
CEORL-HNS Executive Office
c/o Mondial Congress & Events
T +34.618 533 894
gloria.casanova@ceorl-hns.org 
Contact person: Gloria Casanova

  

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