DSTC surgeon registration 2023

Definitive Surgical and Anaesthetic Trauma Care Course 2023

I would like to register for course A on 7 & 8 November 2023 as:

Surgeon (DSTC) (4/24)

Orthopaedic Surgeon (5/6)

Invited by Dutch Ministery of Defense (0/6)

I would like to register for course B on 09 & 10 November 2023 as:

Surgeon (DSTC) (8/24)

Orthopaedic Surgeon (3/6)

Invited by Ministery of Defense (0/6)

Position

Resident

Medical specialist

Other/ not applicable

Start of Surgical Training

Medical specialism *

Traumatology/surgery

Orthopedics

Other/ not applicable

Experience in trauma cases *

Less than 10 cases

Between 10-30 cases

More than 30 cases

Other/ not applicable

Dhr/Mw *

Titel

Voornaam *

Achternaam *

Land *

Postcode *

Huisnummer *

Straat *

Plaats *

Date of birth: *

E-mailadres *

Function

Organisation

Z-number (only for Radboudumc employees)

BIG nr. (in case you do not have a BIG nr please fill in zero) *

Food Allergy or Dietary Wishes

Would you like to join the dinner on day 1 of the course (included in the price)

Yes

I agree with the general terms and conditions *

Totaal: € 0,00

Registration Form