EUROPEAN UNION of MEDICAL SPECIALISTS European Board of Radiology

EUROPEAN UNION OF MEDICAL SPECIALISTS European Board of Radiology

The European Accreditation Council forAccreditationCouncil in Imaging Continuing Medical Education – EACCME® (ACI)

Institution of the UEMSaisbl

Order of pre-paid applications for the accreditation of E-Learning Materials (ELM)

Select application type (Please consult the document ELM pre-paid applications in case of doubt):

-Individual Module:

Select modules count:

-1. € 500 for 1 accredited module

-2. € 1,000 for up to 10 accredited modules

-3. € 1,500 for up to 20 accredited modules

-4. € 2,000 for up to 30 accredited modules

-5. € 3,000 for up to 40 accredited modules

-6. € 5,000 for up to 50 accredited modules

-7. € 7,500 for up to 100 accredited module

-8. € 10,000 for up to 100 accredited module

-E-platform:

Select modules count:

-1. € 1,000 for up to 10 accredited modules

-2. € 1,500 for up to 20 accredited modules

-3. € 2,000 for up to 30 accredited modules

-4. € 3,000 for up to 40 accredited modules

-5. € 5,000 for up to 50 accredited modules

-6. € 7,500 for up to 100 accredited module

-7. € 10,000 for more than 100 accredited modules

-App:

Select modules count:

-1. € 1,000 for up to 10 accredited modules

-2. € 1,500 for up to 20 accredited modules

-3. € 2,000 for up to 30 accredited modules

-4. € 3,000 for up to 40 accredited modules

-5. € 5,000 or up to 50 accredited modules

-6. € 7,500 for up to 100 accredited module

-7. € 10,000 for more than 100 accredited modules

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The above fees are VAT excluded.

Customer:

Contact first name:

Contact last name:

Address:

City:

Postal/Zip code:

Country:

Contact email address:

Please select your VAT status from the following options:

EU registered

EU not registered

EU exempt

Outside EU

If applicable, please enter your VAT number without any space between the country code and the digits

VAT number:

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Please note that you will only be able to use your pre-paid modules once we have received your payment.

Union Européenne des médecins specialistes – International non-profit organization, rue de l’Industrie 24 BE-1040 Brussels BELGIUM – registered in Brusselswith VAT number BE 0469.067.848European Board of Radiology, S.L.U. , Passeig de Gràcia 86, Ático, 08008 Barcelona, SPAIN Inscrita en el Registro Mercantil de Barcelona, Book 42.942, Page 117, Number B-420225, NIF-B65668006 Bank Data: European Board of Radiology, S.L., ACCOUNT NR. 0182 0171 81 0201622776IBAN ES6201820171810201622776, SWIFT BBVAESMMXXX 1 / 2