Prufunámskeið

Skráning stendur yfir

Nafn (Name): *

Kennitala (Social Security Number): *

Non-Icelandic Social Security Number

Heimilisfang (Address): *

Netfang (Email): *

* *Staðfesta netfang (Confirm email):

*Sími (Tel): *

Ekki félagi í FS / félagi í kjaradeild FS: 1.500 (Not a member of FS / only a member of kjaradeild FS: 1.500)
Í Fagdeild FS: 1.000
(Fagdeild FS member: 1.000)

Greiðandi er sami og þátttakandi (Payer and participant are the same person)
Greiðandi er annar en þátttakandi (Payer and participant are not the same person)

*Nafn (Name): *

*Kennitala (Social Security Number): *

Non-Icelandic Social Security Number

*Heimilisfang (Address): *

Annað sem þú vilt koma á framfæri (Comments)

*Ég samþykki skilmála Félags sjúkraþjálfara
(I accept the terms and conditions)