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DKGH First C y stic Fibrosis Eastern European Conference HIIM Šalata 12 100000 ZAGREB, Croatia

DKGH First C y stic Fibrosis Eastern European Conference HIIM Šalata 12 100000 ZAGREB, Croatia FAX:+385-1-45 96 942. CONGRESS REGISTRATION FORM. Please fill in this form in CAPITAL LETTERS and send by e-mail to: nina.canki-klain@zg.t-com.hr Or fax/send it back to:.

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DKGH First C y stic Fibrosis Eastern European Conference HIIM Šalata 12 100000 ZAGREB, Croatia

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  1. DKGH First Cystic Fibrosis Eastern European Conference HIIM Šalata 12 100000 ZAGREB, Croatia FAX:+385-1-45 96 942 CONGRESS REGISTRATION FORM Please fill in this form in CAPITAL LETTERS and send by e-mail to: nina.canki-klain@zg.t-com.hr Or fax/send it back to: Note that any registration has to be guaranted by the appropriate payment. Use one form per delegate and accompanying person (photocopied registration forms allowed). • REGISTRATION FEES (in EURO)include: • Admission to all scientific sessions, exhibition • Welcome reception • Abstract book and Programme • Coffee/Tea during breaks • Lunch and dinner on November 29 Dr./Prof./Mr./Mrs (please circle) FAMILY NAME FIRST NAME INSTITUTION/COMPANY DEPARTMENT ADDRESS ZIP CODE CITY COUNTRY TEL FAX E-MAIL  Please tick here if you do not wish your data printed in the abstract book.

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