Registration - Dysgraphia Workshop - & / or - ADHD, Dyslexia, Dyspraxia & Dyscalculia Parent / Teacher meeting

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Dysgraphia Workshop - Sat 19 Oct - 14:00 - 15:30 - with Klara Leclercq Backes - Graphologue ABG et Graphothérapeute GBGT et SBT

ADHD, Dyslexia, Dyspraxia, Dyscalculia Parent / Teacher meeting - Sat 19 Oct - 16:00 - 18:00 - facilitated by Saretha Naude

Both events on Sat 19 Oct - the Dysgraphia Workshop and this Parent / Teacher workshop - are at the IBC (International Baptist Church), Lange Eikstraat 76, 1970 Wezembeek-Oppem

Family Name: *

First Name

Email address - almost all of our info is delivered by email *

Would you like us to add your email to our mailing list? Your email would remain on the mailing list until you unsubscribe, and our mailing list is not shared with anyone

Yes

I think you already have my email address

Clear selection

Please could you tell us how you heard about these events?

From a School

From a Friend

Our newsletter

Facebook

Twitter

Clear selection

It might be useful to have your mobile phone number - only to contact you about these particular events (if need be)

Are you a Member of ADHD, ASC & LD Belgium for the year 2019 to 2020? * *

Yes we have a Family membership (both partners & children over 13 are included in a family membership)

Yes I am part of a School Membership - please see next question *

Yes I have joined as a Professional (eg a Psychiatrist, therapist etc) *

Yes I have joined as a Full-time Student / Non-waged person

No, I will attend as a Non-member

I would like to become a Member, please send me the Membership form

* I am part of a School Membership - please give the name of your School - Professionals should also give the name of their organisation

Would you like to attend the Dysgraphia Workshop - Sat 19 Oct - 14:00 - 15:30 - with Klara Backes. Come & learn what Dysgraphia is..... *

Yes - Members 2019 to 2020 - (Family, school, professional) - Dysgraphia 12.50 euro (per person)

Yes - Members 2019 to 2020 - (students / non-waged) - Dysgraphia 4 euro (per person)

Yes - * Non-members - Dysgraphia 25 euro (per person)

Yes - * Non-Members - (students / non-waged) - Dysgraphia 8 euro (per person)

NO - I'm ONLY coming to the ADHD, Dyslexia, Dyspraxia, Dyscalculia meeting for Parents & Teachers

NO - I'm coming to BOTH Parent/Teacher Meeting + Dysgraphia workshop (prices below)

Would you like to attend the ADHD, Dyslexia, Dyspraxia, Dyscalculia meeting for Parents & Teachers - Sat 19 Oct - 16:00 - 18:00 - this is your opportunity to ask questions... *

Yes - Members 2019 to 2020 - (Family, school, professional) - Meeting 0 euro (per person)

Yes - Members 2019 to 2020 - (students / non-waged) - Meeting 0 euro (per person)

Yes - * Non-members - Parent/Teacher Meeting 12.50

Yes - * Non-members - BOTH Parent/Teacher + Dysgraphia for 30.... (instead of 12.50 + 25)

Yes - * Non-Members - (students / non-waged) - Parent/Teacher Meeting 4

Yes - * Non-Members - (students / non-waged) - BOTH Parent/Teacher + Dysgraphia for 10.... (instead of 4 + 8)

NO - I will only attend the Dysgraphia Workshop - Sat 19 Oct - 14:00 - 15:30

Payment details

To complete your registration, please transfer the appropriate amount into our bank account as follows and send us a proof of payment to info@adhd-edu.be : 001-5695038-50 or IBAN: BE86 0015 6950 3850 // BIC: GEBABEBB // Sat 16 Oct 2019 + Your name (School if applicable)

GDPR

"We are in full compliance with the new Data Protection Laws that went into effect on 25 May, 2018. We therefore will not share your personal information with third parties." Please read our GDPR policy here https://buff.ly/2u2H34J

Photos

We may take photos of the event & share crowd shots - if you don't want your photo taking please let us know

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms