PERSONAL INFORMATION:

First Name (required)

Last Name (required)

Job Title (required)

Institution (required)

Address / P.O.Box

City (required)

Country (required)

Phone (required)

Fax

Your Email (required)

Accommodation Required

REGISTRATION FEES:

The registration fees include attendance to all plenary sessions, entrance to exhibition halls, coffee breaks, lunch and certificate of attendance.

BANK TRANSFER DETAILS:

Account Title: NEURO SPINAL HOSPITAL CONFERENCES
IBAN Number: AE710260001011034077703
Bank Name: EMIRATES NBD
Swift Code: EBILAEAD
Bank Branch: JUMEIRAH RD BRANCH
Bank Address: P.O.BOX 777, DUBAI - UAE

Once payment is done please make sure you fax or email the application form together with the bank draft to the following:

THE SECRETARIAT
Dubai Spine Educational Seminar
Neuro Spinal Hospital
Fax: +971 4 342 9979
Email: spine@nshdubai.com

VISA ARRANGEMENTS:
If you require a Visa, please e-mail a clear COLOR copy of your passport to spine@nshdubai.com