APPLICATION FORM


Welcome to the application for the World Master Course "Principles and Practice of Scoliosis Conservative Treatment".

Please submit this form only if you want to apply for the course. If you need more information before applying or if you have any questions about this application, please contact us at online.master@isico.it.

Special discounts for members/delegates of ISPRM/ESPRM/SOSORT, UEMS Board fellows and Board registered trainees, and for participants coming from Low and Lower-Middle Income Countries

The course will officially start in February, 2018. Thank you for your interest in this course organized by Isico. All fields marked with an * are mandatory.


Personal Information

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Language Proficiency

Mark below your proficiency in English (if you are a Native English Speaker, mark N/A for the questions below):



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Professional and Academic Information

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Skills and Expertise
We ask you some questions about your current experience in the conservative treatment of patients affected by vertebral deformities (mainly scoliosis, hyperkyphosis).
Approximately, how many patients affected by vertebral deformities did you visit last year? *



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Approximately, how many braces did you prescribe last year? *



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Do you usually work together an orthotists for the design and the final check of the braces? *

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Do you usually work together physical therapists for the treatment of your patients? *

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In order for us to understand if you are familiar and would adapt well to a distance-learning program and also your group work skills, please respond to the statements below (your responses will not influence your acceptance into the program):



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I can devote 5-7 hours every two weeks to the course, in addition to the 1-hour live lesson. *

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I use email, phone and text messages frequently in my work. *

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I can download software from the web and install applications with no need for assistance. *

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The reasons I am applying for this course are (mark all that apply): *






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Payment

Course fee:
Early bird registration fee 2.500 Euros within 13/01/2018.

After the deadline, full fee 3.000 Euros

Special discounts

Members/delegates of ISPRM/ESPRM/SOSORT, UEMS Board fellows and Board registered trainees have the opportunity to register with the special discount of 20% on the official fees ( 2.000 Euros before the deadline, 2.400 Euros after the deadline).
If you are eligible for this discount, please add your position (fellow/registered trainees/member/delegate) in the final field of the form

Residents in PRM register with the special discount of 50% on the official fees ( 1.250 Euros before the deadline, 1.500 Euros after the deadline).
If you are eligible for this discount, please send us a document to prove it.

People coming from Low and Lower-Middle Income Countries are eligible for these special discounts:
- Lower-Middle Income Countries: 50% ( 1.250 Euros before the deadline, 1.500 Euros after the deadline)
- Low Income Countries: 80% ( 500 Euros before the deadline, 600 Euros after the deadline)


For participants resident in Italy, payment of VAT in addition to the current valid fee is compulsory

The payment must be done via bank wire, to:

Bank account issued to: Isico Tecnologie Servizi srl
Bank Name: Banco Di Desio E Della Brianza, Branch of Vigevano
Bank Address: Via Decembrio, 27029 Vigevano Italy
IBAN : IT18 Q034 4023 0000 0000 0276 900
SWIFT/BIC : BDBDIT22

Please advise your bank to debt you with the banking charges and send a copy of the wire receipt to online.master@isico.it

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