|
Name/Surname*
|
| |
Naiera Zayed
|
|
Place of birth
|
| |
Egypt
|
|
Date of birth
|
| |
11/09/1988
|
|
Fiscal Code (Italy or 000000 if foreigner)
|
| |
000000
|
|
Email
|
| |
naiera.zayed@kuleuven.be
|
| FISCAL DATA |
|
Name/Surname – Company
|
| |
Periodontology & Oral Microbiology, KU Leuven
|
|
Address
|
| |
Kapucijnenvoer 7, Block A, 6th Floor, Laboratory Of Oral Biology.
Leuven 3000
Map It
|
|
VAT n. (only for company or University)
|
| |
Periodontology & oral microbiology, Oral health sciences, KU Leuven
|
|
Fiscal code (Italy of 000000 if foreigner)
|
| |
000000
|
|
Payment
|
| |
Bonifico Bancario
|
|
Ordine
|
| |
| Prodotto |
Quantità |
Prezzo unitario |
Prezzo |
|
Registration fee (social dinner not included)
|
1 |
590,00 € |
590,00 € |
|
No
|
1 |
0,00 € |
0,00 € |
| |
Subtotale |
590,00 €
|
| |
Totale |
590,00 € |
|
|
