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					                                                                                                              for office use   Nº:
                                                                                                              CODE:

                                                           Registration
                         (Registration is only valid after payment has been confirmed/validated)


                          FULL   CONFERENCE PACKAGE,      THURSDAY 8 & FRIDAY 9 NOVEMBER AT ESTG-LEIRIA
                                              (materials, lunch, coffee and tea included)

                  Participant                                                   200€

                  Participant (after 30/7/2007)                                 250€

                Member of supporting organisation                                           Name of organisation:
                                                                                150€
            (before 30/7/2007)*

                 Member of supporting organisation                                          Name of organisation:
                                                                                200€
            (after 30/7/2007)*

                  Student concession (before 30/7/2007)**                       100€

                  Student concession (after 30/7/2007)**                        120€

                                      1 DAY ATTENDANCE ONLY (lunch, coffee and tea included)

                  Standard (before 30/7/2007)                                   100€
                                                                                125€           Thursday 8TH     Friday 9TH
                  Standard (after 30/7/2007)

PRE-CONFERENCE WORKSHOPS, WEDNESDAY 7TH
PLEASE NOTE:   LAST DAY FOR WORKSHOP REGISTRATION IS 20 OCTOBER 2007 (LIMITED NUMBER OF PARTICIPANTS) (lunch is not included)

    One workshop:                             50€          workshop A1: The Didactics of Subtitling (9:30 – 12:00)

    Two workshops:                            100€         workshop B: Audio description (9:30 – 12:00)
                                                           workshop C: Working with statistics (9:30 – 12:00)
   One workshop, student                      30€
concession: **                                             workshop D: Setting up AVT Projects (14:00 – 16:30)
                                                           workshop E: Video Games (14:00 – 16:30)
   Two workshops, student
concession): **                                            workshop F: Dubbing (14:00 – 16:30)

                                              50€          workshop G: Live Subtitling - respeak (9:30 – 12:00)
                                                           workshop H: Project Management (14:00 – 16:30)
                                                           workshop A2: The Didactics of Subtitling (14:00 – 16:30)

    AVT PhD research Forum                    Free            Meeting AVT in Portugal (18.00 – 20.00) (In Portuguese)            Free
(16.30 –18.30)
   * Members of supporting organisations must include evidence of paid-up membership.
   ** Students must include a photocopy of a valid student ID with the registration form.


    DINNER                                              20€       Dietary requirements (please specify)
 Wednesday 7th November 2007

    CONFERENCE DINNER                                   30€       Dietary requirements (please specify)
 Thursday 8th November 2007
                                                                             TOTAL



                                                                                         for office use   Nº:
                                                                                         CODE:

                                               Payment Form
       SURNAME:                                           NAME:
       TITLE:                                             FILIATION:
       FULL ADDRESS:                                      COUNTRY:
       E-MAIL:                                 PHONE CONTACT:
       NAME FOR RECEIPT:
       FULL ADDRESS (IF DIFFERENT FROM THE ABOVE):
       TAX NUBER (IF NEEDED IN RECEIPT):


   METHOD OF PAYMENT


         Cheque in Euros (no other currency accepted), payable to Instituto Politécnico de Leiria, to

    be sent to „Media for All‟ Conference Administrator (see address below). NOTE: All expenses are to be
    covered by the participant.



         By bank transfer:
    If paying by international bank transfer please identify as “M4All”

                                           Bank: Direcção Geral do Tesouro
                                           NIB: 0781 0112 00000001336 40
                                           IBAN: PT50078101120000000133640
                                           SWIFT: TESPPTP1

    Please email/fax transfer proof with your registration form to „Media for All‟ Conference
    Administrator (see address below)      NOTE: All expenses are to be covered by the participant.




         Card Payment (fill in “Card Payment Form” below and send it, by e-mail, fax, post, to „Media for

    All‟ Conference Administrator (see address below).



Please return all forms to:
      Dr. Alexandre Soares – M4All Conference Administrator
      Gabinete de Relações Públicas e Cooperação Internacional
      Escola Superior de Educação
Rua Dr. João Soares – Apartado 4045
2411-901 Leiria – PORTUGAL
Tel: (+351) 244 829 471 / Fax: (+351) 244 829 499
asoares@esel.ipleiria.pt

                                                                                for office use   Nº:
                                                                                CODE:




                                    Card Payment Form
SURNAME:                                                NAME:
TITLE:                                                  FILIATION:
FULL ADDRESS:                                           COUNTRY:
E-MAIL:                                     PHONE CONTACT:
NAME FOR RECEIPT:
FULL ADDRESS (IF DIFFERENT FROM THE ABOVE):
TAX NUBER (IF NEEDED IN RECEIPT):



            VISA:          MASTERCARD:

            CARD NUMBER:                         -                   -      -


            EXPIRY DATE:                /

            CARD SECURITY NUMBER (3 DIGIT NUMBER PRINTED ON SIGNATURE STRIP):



            CARD HOLDER’S NAME:                 DATE:        /

            AMMOUNT:

            AUTHORIZING SIGNATURE (OBLIGATORY):




Please return this form to:

          Dr. Alexandre Soares – M4All Conference Administrator
          Gabinete de Relações Públicas e Cooperação Internacional
          Escola Superior de Educação
Rua Dr. João Soares – Apartado 4045
2411-901 Leiria – PORTUGAL
Tel: (+351) 244 829 471 / Fax: (+351) 244 829 499
asoares@esel.ipleiria.pt

				
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