Title of the Symposium
Summary (less than 400
characters with spaces)
Chair
Institution
Dept.
Country
Phone
Area Código
E-mail
Número de teléfono
Title of the presentation
Name of the Speaker
Institution
Dept.
Country
Phone
Area Código
Número de teléfono
Area Código
Número de teléfono
E-mail
Title of the presentation
Name of the Speaker
Instituion
Depto.
Country
Phone
E-mail
Title of the presentation
Name of the Speaker
Institution
Dept.
Country
Número de teléfono
Area Código
Número de teléfono
Area Código
Número de teléfono
E-mail
Title of the presentation
Name of the Speaker
Institution
Dept.
Country
Número de teléfono
E-mail
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Disclaimer: I agree and I am responsible for the information included in the present form. I also declare that I have informed all the speakers
of this Symposium about the FALAN Congress and they agreed to participate.
Date
Mes
Día
Año
Name
First name
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Last name