Personal Information

I would like to register for

• Medical Pitch Contest
• Symposium for Science and Industry
• Visits to labs / clinics / institutes

Titel

Last Name

First Name

Institution

Position

Department

Email

Phone

Institution address

Street

ZIP

Location

Country

Attendance and payment*

Attendance and payment

• Sponsor
• Employee at a University, hospital or other public research institution
• Student, PhD student or resident doctor

Privacy policy

By clicking on the checkbox and the "Send" button, I agree to the processing and storage of my personal data for the purpose of contacting and further processing on the occasion of the event "MIB Future Panel 2023". I have read the privacy policy (https://www.ukbonn.de/datenschutzerklaerung/) and accept the provisions contained therein. The consent to contact me is given on a voluntary basis and I can revoke it at any time with effect for the future by sending a revocation statement to the e-mail address carolin.steinfort@ukbonn.de. As of receipt of my declaration of revocation, my personal data may no longer be processed. My personal data must then be deleted immediately. The revocation of my consent shall not affect the lawfulness of the processing of my personal data carried out until receipt of my declaration of revocation.

Register