vfb Registration for italian participants – sixth EABCT SIG Meeting on OBSESSIVE-COMPULSIVE DISORDER – May, 17-20 2018 362 Personal InformationFirst Name *Family Name *Place of birth *Date of birth *Address *Postcode/ZIP *Town *Country *Mobile Phone number *E-mail Address *Partita Iva Codice Fiscale * Registration Licensed psychologistPsychotherapistPsychiatristResearcherInstitution (please specify) I wish to attend the social dinner *YesNoHow did i come to know about the meeting? EABCT websiteAPC websiteSIG EABCT ON OCD mailing list (Barbara)Other (please specify) Details of the Bank TransferDate of bank transfer *CRO * PrivacyI accept the Italian privacy policy and terms of use (law 196/2003) *privacy add two numbers of your choicePlease enter any two numbers of your choice (e.g. 42) *This box is for spam protection - <strong>please leave it blank</strong>:
