Trust and Traders

Internal Medicine

This form is for one participant only. Feel free to re-submit this form for additional participants.

In case you need more info please send an email to executive@trust-traders.com

PERSONAL DATA (Please use CAPITAL letter)

City		*Country		Code
Tel		Fax		*Email

ACCOMPANYING PERSON (S)

Family Name	First Name


ACCOMMODATION

Single Room	Double Room
*Date of Arrival	*Date of Departure
*Hotel / Category	*No. of Persons


Copy the remittance slip to be attached. Credit cards : Visa, American Express, etc.. can be used only in hotels and other commercial units. Breakfast and taxes are included. All hotels are at a walking distance from the convention center.

BANK TRANSFER
Trust and Traders:
Account no. 5254709228-002, Byblos Bank
Ashrafieh, Lebanon - St. Nicolas Street
Swift no. BYBALBBX

PS: Fields marked with a (*) are required.