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Application form

Dates and time:

21-24 September 2025
Start of course 13:00 21st
End of course 15:00 24th

Location:
Karolinska University Hospital
Solna Stockholm, Sweden

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* 1. First name

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* 2. Last name

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* 3. E-mail:

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* 4. Physical adress

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* 5. Mobile number

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* 6. Nationality

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* 7. Country of residence

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* 8. Institution / Hospital / Company / Organization

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* 9. Present profession and speciality / field of work

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* 10. Years in specialty/profession

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* 11. I prefer to instruct the following position (indicate by moving by grading your choices):

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* 12. Previous MRMI course year and location

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* 13. ESTES member

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* 14. Preferred method of payment

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* 15. Billing adress for invoice including physical adress and reference

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* 16. Do you have any food preferences or allergies?

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