May 20-22, 1999
("Jellap.doc" Microsoft Word for Windows95 ver. 7.0a)
Department of Otorhinolaryngology
University Medical School of Pécs, Hungary
Registration Form
Name: ________________________________________________________
Institute: _______________________________________________
Address: _______________________________________________
City: __________________________________________________
Country: _______________________________________________
ZIP code: _______________________________________________
Phone: _________________________________________________
Fax: ___________________________________________________
E-mail: _________________________________________________
On-site registration fee (please check one of the options):
( ) DEM 500.00 - with dissection
( ) DEM 400.00 - without dissection
Please sent the completed registration form by mail or fax to:
Attn. Antalovicsné Boros Rita
Address: Department of Otorhinolaryngolgoy
University Medical School of Pécs
2 Munkácsy M.u.
Pécs, Hungary
H-7621
Phone/Fax: +36-72-312-151
E-mail: ent@ent.pote.hu
WWW: http://ent.pote.hu/5orrkurzus/kurzus1.htm