Secure WMA: EHMSG 2024 Invitation Letter

Invitation Letter Request Form

Personal Information

Salutation * Mr. Ms.

Title

First Name *

Family name *

Institution

Department

Street Address*

Postal Code *

City *

Country *

Email *

I am *

Passport information
Please indicate all personal data exactly as stated in your passport!

Nationality *

Date of Birth *

Passport Number *

Passport Issue Date *

Passport Expiry Date *

Confirmation of data

I herewith confirm the accuracy of the above data. I also am a registered participant for the 37th Workshop of the European Helicobacter and Microbiota Study Group taking place from September 12 – 14, 2024 in Porto, Portugal.

Fields marked with * are required!

Invitation Letter Request Form

Personal Information

Passport informationPlease indicate all personal data exactly as stated in your passport!

Confirmation of data

Passport information
Please indicate all personal data exactly as stated in your passport!