Institution/Company/Independent
(*required fields)
Name of Institution/Company/Independent*
Type of Institution/Company (National Radiation Center = NRC, Regional Radiation Center = RRC)
NRCRRCcenterother_centermanufacturercompanynot applicable
Address*
City*
Post-code or ZIP
Country*
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First Participant
Last name*
First name*
Title (Mrs., Mr., Dr., Prof.)
Telephone number with international code
Email address*
Symposium - Do you intend to make a presentation at the IPC/FRC/IPgC Symposium?
YesNoPossibly
Welcome Drink* - Will you be joining us for a complimentary Welcome Drink on Sunday 21 September? The exact time and location will be announced soon.
YesNo
Conference Dinner* - Will you be joining us for the Conference Dinner? The exact time and location will be announced soon. (Extra charge will apply).
*If "yes", do you have any meal preferences?
No preferencesVegetarianVeganAllergiesOther If you chose "other", please let us know via team-office@pmodwrc.ch
*Consent for photos and videos
We'd love to capture some great moments! Do you agree to be featured in our photos and videos on social media, IPC participants poster and website? YesNo
Portrait Photo - Please send us a portrait photo for a security pass. If this is not possible then we can take a photo onsite.
Second Participant
Last name
First name
Email address
Do you intend to make a presentation at the IPC/FRC/IPgC Symposium?
No preferencesVegetarianVeganAllergiesOther If you chose "other", please let us know via teams-office@pmodwrc.ch
We'd love to capture some great moments! Are you okay with being featured in our photos and videos on social media, IPC participants poster and website? YesNo
Portrait Photo* - Please send us a portrait photo for a security pass. If this is not possible then we can take a photo onsite.
Third Participant
Fourth Participant
Questions or Comments?
