Abstract submission form DEBS 10-11 March. 2022

Title

First name

Family name

E-mail address

Phone number

Institute

Abstract upload (if preferred) :

Please use font 12, ARIAL and upload your abstract in PDF or docx format. Do not include figures or tables in the abstract. 300 Words limitation.

Country

I would like to be eligible for the Young Investigator Award.

Yes No (Click "Yes" or "No").

Remarks

Please note that your registration is only final once we have received your payment.
As the number of participants is limited, we kindly ask you, to settle your payments as soon as possible to ensure your spot.

Registration cost are € 185.-
This includes access to the conference, meals, accommodation and the social program.

Herewith we kindly request to transfer this amount to the following bank account:

Account holder : St. Sanquin Bloedvoorziening

IBAN Number : NL39 ABNA 0636 6379 21
SWIFT/BIC Code : ABNANL2A
Reference: RES00030 DEBS meeting 2022 (please clearly indicate!)

We wish to thank you for your registration and are looking forward to seeing you in March at De Beukenhof, Biezenmortel, NL