EARLI SIG 19 Religious and Spiritual Education Conference

University of Malta, 26th – 28th August, 2010

PERSONAL DETAILS (in block letters)

Surname:

First Name:

Institutional affiliation:

Country:

Tel:

Fax:

E-mail:

Please enter any dietary requirements:

Participant List on Website

Due to the Data Protection Act, please indicate whether we can include your name in a pre-conference list of participants on the website and whether you have any objection to receive material from the University of Malta in the future:

qYES qNO

Cancellations and Refunds of

Cancellations before 15 June will be possible with an e-mail request to and 90% of the fee will be refunded. For cancellations between 16 June and 1 August 50% of the fee will be refunded, after 2 July 2010 there will be no refund.


Fees

The fees include 3 nights accommodation at a 3* hotel, 3 buffet lunches, 1 formal dinner, 2 informal dinners, coffee breaks, conference registration and material, and transport from hotel/mtg venue/rtn. Participants who would like to extend their stay in Malta are kindly asked to email Lucienne Bugeja ()

Please fill in what is applicable.

q I am an EARLI member (ID …………………………….) I pay a fee of 280 EURO (before 15 April 2010)

q I am an EARLI member (ID:…………..………………..) reading for a doctorate at……………………..…………. (university),

I pay a fee of 240 EURO (before 15 April 2010)

q I am not an EARLI member. I pay a fee of 350 EURO(before 15 April 2010)

q I am not an EARLI member but I am reading for a doctorate at……………………..…………. (university) I pay a fee of 300 EURO (before 15 April 2010)

Participants sending their complete registration form AFTER the 15th April 2010 are required to add 50 Euro to the above fees.

Payment may be effected by:

·  Credit card q VISA qMASTERCARD (Please tick)

Name of card holder:

I authorize you to charge € to my credit card

Card Number:

CVV Number (last 3 digits at back of card):

Expiry Date:

Signature of card holder:

·  OR by Bank transfer (net of charges) to the following bank account held in the name of the Foundation for International Studies.

Bank of Valletta p.l.c. 45, Republic Street, Valletta VLT 1113

Bank Account no. 40017392839

IBAN no. MT47VALL22013000000040017392839

Sort Code VALLMTMT

Date of transfer: Please ensure that when sending a bank transfer you quote Sort Code and IBAN. Please also quote reference EARLI SIG19 2010.

Please complete this booking form and return it to:

Ms Lucienne M. Bugeja

Conference and Facilities Manager, Foundation for International Studies Ltd.

Valletta Campus, Old University Building, St. Paul Street, Valletta VLT 1216 – MALTA

Tel: (00356) 21 234571, (00356) 21 234121/2 ext. 202. E-mail: .m

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