International Academy for Research in Learning Disabilities

Conference Registration Form

42nd Annual IARLD Conference

Ghent, Belgium

July 1st-3rd 2018

Please complete this form and submit to

For questions please contact Prof. Dr. AnnemieDesoete at

Please check on of the following titles:

____Dr. ____Prof.____Ms.____Mr. ____Mrs.

Name: ______

Title and Affiliation: ______

Department:______

Address:______

City/State/Zip:______

Country: ______

Office Phone: ______

Other Phone: ______

E-mail: ______

Payment Deadlines

Early registration deadline: [insert date]

  1. Conference rate

Mark the correct amount below

Early (by March 31, 2018) / After March 31, 2018
Active Member rate / [€345] / [€400]
Retired Member rate / [€275] / [€330]
Non-Member rate / [€365] / [€420]
Student rate* / [€180] / [€245]

* Current Student ID required for proof of student status

  1. Guidedtour – 1st July 2018

Discover Ghent and taste some local products

€20 per person – Add this amount to your registration payment (e.g. paypal.com)

___ Number of guided tour tickets

  1. Banquet dinner– 2ndJuly 2018

Restaurant Oude Vismijn, Rekelingestraat 5, 9000 Ghent

€60 per person – Add this amount to your registration payment (eg. paypal.com) (This amount includes the cost of alcoholic beverages and coffee)

___ Number of banquet tickets (limit of 3 per person)

Dietary restrictions:

The information will be provided to the Chef 7 days prior to the Banquet.

  1. Summary

Sum
Conference rate / EUR
Guided Tour / EUR
Banquet diner / EUR
TOTAL / EUR
  1. Accommodation

You will need to make your own reservations for your accommodation. We suggest you book early as Ghent has numerous conferences each year and accommodation may be restricted. Information about accommodation options has been placed on the IARLD website.

  1. Payment

You have the choice between 2 ways to pay the amount due:

All credit card payments must be made using PayPal in Euro; use your PayPal account, or open one (free) at paypal.com. When prompted for the address to send the money, enter the following PayPal. Me link:

Please note as reference: your name – IARLD 2018

OR

You can pay by bank transfer on the account of:
Arteveldehogeschool VZW
Hoogpoort 15
9000 Ghent
Belgium
IBAN: BE14 4460 2408 9183
BIC:KREDBEBB

Bank Adress:KBC Kouter

Kouter 175
9000 Ghent
Belgium

Please note as reference: your name – IARLD 2018

Please mark your payment choice:

Pay Pal
Bank transfer