Registration - Symposium Institut Cochin 2025 "Long COVID and other Post-Acute Infections: from symptoms to mechanisms" Please register online below, before November 21, 2025. You must have JavaScript enabled to use this form. Family name / Nom First name / Prénom Institute, company / Institut, entreprise Team or department / Équipe ou service City / Ville Country / Pays Email address Email address Email address confirmation Lab Postal Address / Adresse postale du laboratoire Telephone number - Select - Non academic researcher Academic researcher Engineer Post-doc PhD student Speaker Organizer Sponsor representative Internship Other Position / Statut YES NO Do you wish to attend the Lunch? / Souhaitez-vous participer au déjeuner ? - Select - Non academic researcher or engineer: 160 € Academic outside Institut Cochin: 100 € Academic at Institut Cochin: 50 € Student outside Institut Cochin: 40 € Student at Institut Cochin: free Organizer, speaker: free registration fee categories / Tarifs d'inscription - Select - Purchase order Bank check Wire transfer Bank card NONE Method of payment / Moyen de paiement After submission of your registration form, you will receive a proof of registration at the email address you provided. Administrative contact for any question about the payment process: apemm.cochin@gmail.com For payment by purchase order, the orders must be addressed to: APEMM, 24 rue du Faubourg St Jacques, 75014 PARIS. Please ask your administrative manager to group the registrations of team members in order to generate a single purchase order For payment by check, send the check (payable to APEMM) and the proof of registration, to APEMM: 24 rue du Faubourg St-Jacques, 75014 Paris For payment by wire transfer: ASSOC ETUDE MALADIES MOLECULAIRES - CRÉDIT MUTUEL, IBAN : FR76 1027 8061 8600 0217 0800 352 ; BIC : CMCIFR2A For payment by bank card, please pay online via Hello asso platform: https://www.helloasso.com/associations/apemm/evenements/symposium-2025 Full billing address (if different from the above address) / Adresse où envoyer la facture (si différente de la précédente) Leave this field blank Contacts For organization issues Contact by email For payment issues Contact by email