TO BECOME A MEMBER

To become a Member, fill in the form.
After the registration you will need to provide for the payment of 30 €
by bank transfer or credit card

(* = Compulsory field)
  PERSONAL DATA AND CONTACT DETAILS
Name *
Surname *
Date *
of birth
/ /
Zip Code *
Country *
Address *
Telephone *
Hospital / * Institute
Speciality*
Tax code
ID / *
Passport number
E-mail *
Password *
  PRIVACY

I authorize EURAMA Association to handle my personal data according to the Italian Privacy Law 196/03.

* I authorise the processing of my personal data.
 
  PAYMENT METHOD

CREDIT CARD
You will be redirected to the secure payment platform of Intesa Sanpaolo Bank, "SETEFI".
Payment by credit card with immediate results.



PROCEED TO PAY BY CREDIT CARD

BANK TRANSFER
You will be redirected to a page with all the information to make the bank transfer. You will receive an e-mail confirmation when checking the actual crediting of the bank transfer to our account.


PROCEED TO PAY BY BANK TRANSFER