Registration ECTMIH Academy

Thank you for your interest in attending the ECTMIH Academy 2025 in Hamburg. If you would like to register, please fill in the following form and confirm by clicking "Continue”.

The registration fee for the ECTMIH Academy day, including drinks, snacks, and certificate of attendance is:

- 95 Euro for participants from high income countries
- 55 Euro for participants from low- and middle income countries

Please note that we recommend that you arrange your own seminar cancellation insurance, to protect yourself against potential financial risks from cancellation fees.

Verification for LMIC participants

Participants living or working in one of the LMIC countries are kindly asked to provide proof of residency during the registration process. The proof of residency should be provided in English and can be any of the following, not including your passport:
• Employment contract/proof from employer or university
• Proof of residency in LMIC no older than one year
• Copy of a home rental contract in your name (document must be dated within the last year)
• Phone/Utility bill in your name (document must be dated within the last year)

Personal Data

Participant Type*

Academy participation \| Standard
Academy participation \| Member LMIC

Academy participation | Standard

Academy participation | Member LMIC

Gender identity (will not be displayed on name batch)

Degree

First/Middle Name*

Last Name*

Nationality*

Tax id

CME

Consent to data sharing for future ECTMIH conferences

I consent to my data being shared for future ECTMIH conferences:*

Yes

Address

Institution

Department

Addition to address

Street*

ZIP*

City*

Country*

Additional e-mail address for sending invoices

Additional e-mail adress:

Communication

Phone Number

Fax

Email*

Email (Verification)*

Professional background
Please provide the following information about your professional background.

I am a student:*

Name of current employer/higher education institution*

Your job position (e.g., researcher, lecturer, clinician etc.):

Education
Please provide information about your academic degrees - in chronological order.

Degree 1:*

Field of study:*

Name of institutions:

Degree 2:*

Field of study:*

Name of institutions:

Degree 3:*

Field of study:*

Name of institutions:

Workshop preferences
With the following query you can indicate your workshop preferences when booking the ECTMIH Academy. Please note that you can attend only one workshop per time slot. We will try our best to meet your preferences, but cannot guarantee it in all cases.

Time slot 10:30 to 12:00

Preference 1*

Preference 2*

Preference 3*

Time slot 13:00 to 14:30

Preference 1*

Preference 2*

Preference 3*

Time slot 15:00 to 16:30

Preference 1*

Preference 2*

Preference 3*

For visa application: Please fill in the following details in case you need an invitation letter.

Place of birth

Date of birth

Nationality

Passport - Date of Issue

Passport No.

Passport - Date of Expiry

Please note: invitation letters can only be sent after your payment has been received.

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