Surname: First name: Address: Country: Job title: Prof.Dr.Mr.Mrs.MissMsSpecialisation: ENT Neurosurgeon Hospital affiliation: Work address: Telephone number: Email: What is your aim from this course? We will confirm your registration by email and post once we have received the fees (1200 euros) to the course account. ABN-AMRO Bank Amsterdam, PO Box 12771, 1100 AT Amsterdam bank account number 45 10 37 596 name of the account ‘St. Aero’ IBANnr. NL52ABNA0451037596 BICnr. ABNANL2A *Payment by direct credit transfer in Euro, ‘in full’ to ensure no commission fees or bank charges are deducted.