Title (required)
 Prof Dr Mr Mrs Ms

First name (required)

Surname (required)

Job Title (required)

Department (required)

Organisation (required)

Address (required)

Zipcode (required)

Country (required)

Telephone (required)

E-mailaddress (required)

Clinical Speciality (required)

Years of experience in Care Pathways (required)

Pathways developed & Motivation to join (required)

Yes, I would like to participate in the International Masterclass & Round Table 2018. By participating in the Master Class, I will become a member of the European Pathways Association. I have read the rules of membership (see Join E-P-A) and I consent to my details being shared with other members.

When your application is accepted, you will receive an invoice for the fee of € 1.575,-. You are only an official delegate after your deposit is received by the E-P-A.