Skip to content
Event
The congres
President message
program
Speakers
Accomodation
Douala
FAQ
Contact
Event
The congres
President message
program
Speakers
Accomodation
Douala
FAQ
Contact
registration
English
Français
English
Register
Choose a language
Français
English
Contact
Contact
We Are Here to help
Contact Us
Email
cmcu2021@gmail.com
Phone
+237 698 87 39 45
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Full name
*
Object Message name
E-mail
*
Object
*
Message
Send Message
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Full name
*
Date of birth
*
/ Address Tarif
E-mail
*
Gender
*
Male
Female
Medical Specialty
*
--- Sélectionner un choix ---
Urologist
General Surgeon
Gynecological Surgeon
Resident
Other
Years of Experience
*
--- Sélectionner un choix ---
0 - 2 years
3 - 5 years
6 - 10 years
+ 10 years
Institution / Hospital / Clinic
*
Country of Professional Residence
*
WhatsApp Number
*
Professional Email Address
*
Hands-on Training
*
No (Congress Registration)
Laparoscopy Surgery
Robotics Surgery
Expected Arrival Date
*
Emergency / Local Contact Name
Emergency / Local Contact Phone Number
Emergency / Local Contact Email Address
Hotel Accommodation
*
--- Sélectionner un choix ---
Krystal Palace
Akwa Palace
Hôtel La Falaise
Somatel Hôtel
Visa Support Required
*
Yes
No
Intended Payment Method
*
--- Sélectionner un choix ---
Bank Transfer
Mobile Money
Credit Card
On site
Special Needs (allergies, mobility, other)
Accord RGPD
*
I confirm my registration request and agree to the use of my personal data for the organization of the master class.
*
Tarif choisi
Continue
x
FERMER
