4° European R2S2 Robotic Rehabilitation Summer School. 18-23 September 2023

Enrollment form

(* mandatory field)

Name *

Surname *

Place of birth *

State / Province / Region *

Country *

Date of birth (gg/mm/aaaa) *

Street Address *

City *

ZIP/Postal Code *

State / Province / Region *

Country *

Phone *

email *

Fiscal Code (for Italian participants only)

Profession *

DATA FOR PAYMENT
Please send a copy of bank transfer of € 400,00 to Kos Care Srl, at:
IBAN IT30R0306969120100000002837 SWIFT CODE BCITITMM
Reason for payment: [Participant's name] - Robotic school, name/surname of the participant.
Please do contact the Secretariat before sending the registration in order to check the availability. Phone: + 39 0733 689400 - formazione@kosgroup.com

File (pdf, tiff, jpg) *

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DATA FOR INVOICE
The invoice must be addressed to:

Company name or Full name

Fiscal Code/ V.A.T number

Tax code (if any)

Address

City

ZIP/Postal Code

State / Province / Region

Country

email (invoice will be sent by email)

Privacy *

I declare that I have read the information according to Article 13 of EU Regulation No. 2016/679 regarding the processing of my personal data available at this link.

EVENT SECRETARIAT

Kos Care
Via Aprutina, 194 - 62018 Porto Potenza Picena (MC) - Italy
Tel. +39 0733 689400 - fax +39 0733 689403
e-mail: formazione@kosgroup.com