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

Early bird conference fees - (before 30 April 2024) (mandatory)
—Please choose an option—330,00 € (not ASLERD member)270,00 € (Regular ASLERD member)180,00 € (Student not ASLERD member)150,00 € (Student ASLERD member)60,00 € (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