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


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

  

SUBSPECIALTY (please select all that apply):




             
  
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 society has 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

Only payment by bank transfer is possible:
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.

At the end of the process, when submitting the application, you will receive a confirmation email including the bank account details detailed above.


              
  
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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