Personal Data Form

Please register your details to create a user account. Your user account enables you to submit an abstract, register for the conference, book a hotel and more.

Title (Degree - Dr., Professor, etc.)

First name

Last name

Post-nominal letters (Ph.D., M.Sc. etc.)

Organisation

Department

Street, Number

Town/City

Post/ZIP code

Country

Phone

Enter the number in full international format starting with the + ( e.g.: +44 xxx xxx xxxx)

E-mail

Different billing address (for invoicing)

Organisation

Street, Number

Town/City

Post/ZIP code

Country

Company identification number

VAT number / Tax ID

Based on your registration (in the following step), your personal data filled out in the registration form are going to be processed by GUARANT International spol. s r.o., registration no. 45245401, having its registered seat at Českomoravská 19, 190 00 Prague 9, Czech Republic, contact: info@guarant.cz as the controller, for the purposes of arrangement of your participation in the event. This processing is necessary for the performance of a contract between you and the controller. Upon your registration you confirm that you have familiarized yourself with Information on processing of personal data, containing detailed information on processing on personal data by the controller. A participant of 27 th WONCA Europe Conference 2022 also acknowledges that list of participants including their email addresses will be distributed to Belgian Society for General Practitioners/Family Physicians having its registered seat at Domus Medica vzw, Lange Leemstraat 187, 2018 Antwerpen, Belgium and WONCA Europe Office having its registered seat at Poljanski nasip 58 / 1000 Ljubljana, Slovenia.