Opet Membro do
Health Technology
Assessment International
Edifício do IST,
Gabinetes 2-N11.7 e 2-N11.9,
Taguspark, Porto-Salvo
2780-990 OEIRAS,
Tel. 214 233 245 | Fax 214 233 252
Email. opet@opet.pt

Registration Form for ECPP
Event Name *
This page is protect by A SSL Stamp and your submitting data is protected with an encriptation engine !!! Be aware that in the momment you enter the personal or company data and you send the registration form to OPET, you are being committed with OPET Privacy Policy Data and the General Portuguese Law - Data Privacy Act Diploma.You are also allowing Opet to use yourself image in videos, photographs and digital and material publishments
(This event will not be broadcast by any internet or media means and must be attended phisically, in the dates and local of it´s occurrence, by all participants )
Participant Name: *
Promotional Code of Inviter Entity:
Professional Entity Name *
Academical/Professional Position:
Address: *
Phone Contact: *
Fax:
Email: *
Fiscal Identification Number: *
To complete your registration you should make the payment by banking transfer and send the payment confirmation to opet@opet.pt.

Afterwards OPET will send you the confirmed registration form.If you are invited by a Event Sponsor Entity your entrance in the event will be free of costs.



BANK ACCOUNT DATA

Bank Account Name : OPET Observatório de Prospectiva da Engenharia e da Tecnologia.

Identification Bank Account Number : 001000003765635000160

Bank Name - BPI BANK

IBAN - Banking Account International Number - PT50 0010 0000 3765 6350 0016 0

SWIFT/BIC CODE - BBPIPTPL



If you have any doubt or any question you may adress us at the email - opet@opet.pt.

Our Best Regards,



OPET - Observatório de Prospectiva da Engenharia e da Tecnologia.

Edifício do IST - Gabinete 2 - N9.9 TagusPark, Porto Salvo 2780 - 990 OEIRAS-Portugal-Europe

Email: opet@opet.pt

NIPC: 510 962 157