CLASTA Conference Subscription Form – non members

I would like to register for the CLASTA Web Conference of the 17th and 18th May 2024.

Surname

Name

E-Mail

Telephone

EMPLOYMENT
LecturerResearch managerResearcherProfessorFellowAssistantPhD StudentPost doc studentPsychologistSpeech and language therapistPhysiotherapistNeuropsychologistPediatricianDoctors specialized in child and adolescent neuropsychiatryPhoniatrics and otorhinolaryngologyOther (please specify)

DESCRIPTION
Universities and Research institutesPublic health institutionsClinical practiceOther (please specify)

AFFILIATION AND WORKING PLACE (location/institution, address and telephone number)

REGISTRATION TYPOLOGY
non member lecturer or professional: € 60Other non members (students, PhD Students, Post doc students, free lance): € 30

PAYMENT NOTICE: data - date - account in the name of - CRO (if possible)

NORMATIVA PRIVACY (For further information click here)

By submitting this form I agree to the processing of personal data in accordance with Law no. 196/2003