Register - Congreso Intercontinental de Terapéutica Dermatológica 2022

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Registration Form

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Personal Information

Assistance Modality:*

In person

Virtual

Do you have a special registration or scholarship code?

Yes, I have a code.
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Type your code*

YOUR COUPON IS OK!

Name*

Last name*

Email address*

Your password must be at least 8 characters long!

Password*

Confirm password*

Cellphone*

Office Phone Number sss*

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Residential Information

County*

Zip Code

State*

City*

Province*

Street

Number

Assistance Category

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Partner of International Society of Dermatology Partner of International Society of Dermatology Member of International Society of Dermatology Member of International Society of Dermatology Member of Subsidiary Society Member of Subsidiary Society General registration General registration Residents or students Residents or students
Inscription cost:

Service*

Service Letter*

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Residents or Students, it is very important that you attach a copy of your service letter in pdf file format or png, jpg or jpeg image format.

Specialty Card*

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Non-members, it is very important that you attach a copy of your specialty card in pdf file format or png, jpg or jpeg image format.

Do you want to include pre-day workshop day 21?

Yes, include pre-day workshop day 21:
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Do you want to include pre-day workshop day 22?

Yes, include pre-day workshop day 22:
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