SIGN UP REGISTRATION FORM: Company and position: (if applicable) Name: (initials + surname) Address: (required) City/state/Zip & Country: (required) Phone number: E-mail: (required) Other means of communication being: Will you be bringing a service dog? YesNo Hearing status: deafhearinghard of hearingsudden deaf Other: I attend this congress: for professional purposespersonal interestI’m an interpreter working for or with ; ………………(your clients name if applicable)I’m an interpreter not working at the convention Other: The congress program covers three days. You can also choose to visit the congress for one or two days only. The price for three days is € 150,- The price for two days is € 125,- The price for one day is € 75,- Make your choice here: I shall attend all three days. YesNo I shall attend two days: I shall attend one day: Deadline registration date is 15th of March 2019 The price as mentioned includes: Welcome with coffee and thee Coffee, thee and water during the workshops and lectures An extensive lunch buffet in the restaurant Celebrations during lunch A collective excursion on Sunday afternoon On Saturday the three-days-arrangement includes an extensive diner in the restaurant. On the other days can choose where you wish to dine, there are a few nice restaurants in the area or you can dine in the hotel. Diner will be at your own expense. If you’re staying at the hotel Zonheuvel you can communicate your dietary needs with them. If you’re NOT staying at Zonheuvel please inform us about your dietary needs by sending an email to: congres2019@stichtingplotsdoven.nl The Dutch association of the late- and sudden deafened has arranged a special price for visitors of the congress. Please indicate whether you wish to attend dinner on Friday and/or the excursion on Sunday. I shall be attending diner on Saturday: YesNo I shall join the excursion on Sunday afternoon: YesNo We ensure you it will be worth your while! Communication Off course our focus will be on the various means of communication. The official language during the congress will be English. English card service will be available during the workshops and plenary sessions. The association will provide NmG-interpreters and speech-to-text-reporters who will be translating English into Dutch. Loop wiring will available during the entire congress. If your needs are not met with what we offer above please let us know what means of communication you would like to use: Sign Language-interpretertactile- signing -interpreter I will bring my own interpreter (name and language): Please have your interpreter register and sign in for the convention mentioning your name. The interpreter is welcome to pay the contributors rate. When you would like a different kind of interpreter or need another aid, please contact us at congres2019@stichtingplotsdoven.nl Payment A confirmation of your registration will be send to you by mail. After confirmation you’ll be requested to pay the due amount with 17th of March 2019 as deadline for payments. Payment of the amount from foreign countries: Please use the following: IBANnr NL54 INGB 0000 0820 80 and Bic/Swift code INGBNL2A