SLERD 2024 - Registration form

Name (mandatory)

Surname (mandatory)

Birth Date of birth (mandatory)

Nationality (mandatory)

Affiliation

Address (mandatory)

City (mandatory)

ZIP

Nation (mandatory)

Fiscal code

Email (mandatory)

Phone number

Regular conference fees (mandatory):
—Please choose an option—190,00 € (on-line not ASLERD member)130,00 € (on-line Regular ASLERD member)120,00 € (on-line Student not ASLERD member)90,00 € (on-line Student ASLERD member)70,00 € (on-line School Teachers)

Payment mode (mandatory)
Bank transfer (with no charges for SLERD)Paypal/Credit Card

Annotations (i.e. specific food needs, disabilities, etc.)

I agree that the data provided with this form are used by ASLERD for organizational purposes limited to SLERD 2024 conference