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Author for Correspondence |
Title: |
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First Name : |
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Family Name : |
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Name of Institution or Hospital : |
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Address: |
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Zip Code: |
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City: |
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State/Province: |
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Country: |
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Phone (Include country & area codes): |
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Fax: |
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E-mail: |
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Date of birth: |
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Area of origin: |
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Topic |
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Type of Presentation preferred |
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Oral Communication
(Presentation will be given in the English language only, supported by video presentation from PC only)
Poster
(dimensions 70 cm. Width, 100 cm height)
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Abstract File |
Title : |
Title should be in capital letters
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Presenting Author’s Name: |
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Authors, including the Presenting Author |
Authors should indicate initials of the First Name and then the full Family Name, without academic title i.e.: J.P. Smith, F. Rossi. First author is the abstract presenter.
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Affiliations: |
Indicate your short affiliation: Department, Institution, City and Country
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INSERT ABSTRACT FILE: |
File abstract |
Only .doc files are accepted. The file must not contain authors' names for a neutral evaluation by the Abstract Selection Committee.
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Privacy: Information art. 13 D.Lgs 30.06.2003 n. 196 |
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The personal data acquired thanks to the present module is collected for purposes connected to execution of the congress and will be processed using both electronic and non-electronic tools. The data collected will be processed only by appointed personnel (marketing, administration and secretariat employees). The data may be communicated to professionals, hotels, travel agencies, airline and shipping companies, affiliated professional bodies, banks, the Ministry of Health for CME purposes and any other sponsors. Providing data (such as name, surname, address, profession, fiscal code, VAT number, place and date of birth, telephone and e-mail) is compulsory in order to make hotel bookings, register for the congress, issue standard invoices and for CME registration.
The above mentioned data (e-mail address and fax number) may also be used to inform you of our future events providing that you authorise us to do so by ticking the appropriate box. Although refusal to provide authorisation to send communication linked to our activities will not prejudice your registration for the congress, we will not be able to contact you to inform you of any future events.
We would like to remind you that your rights are recognised by article 7 of Legislative Decree nr. 196 dated 30th June 2003, in particular the right to access your personal data, request its modification, updating and cancellation if incomplete, incorrect or collected in breach of the law, as well as, object to its processing for legitimate reasons, by addressing your requests to the data controller at the following address info@venicearrhythmias.org
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I authorise for my personal data to be processed to inform me of similar initiatives or consultancy services provided by the data controllers. |
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Yes
No |
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I would like to receive information by e-mail or fax. |
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Yes
No |
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