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PARTICIPANTS
NAME
FIRST
NAME
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.
INSTITUTION/Organisation
................................................................................................................
FUNCTION
................................................................................................................
ADDRESS
................................................................................................................
................................................................................................................
................................................................................................................
TEL.
(+..........)
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FAX
(+..........)
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E-MAIL
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_______________________________________________________________________________
I
register for the Comenius/Grundtvig In-Service Training Course
No BV-2006-016,
Training
for Adults with Dyslexia Disability-T4ADDY,
September 6-12, 2006, in Pamplona, Navarra-Spain.
Immediately
after receipt of the grant, I will transfer the amount of 1000
EURO to account No
733-3094595-34 (KBC Bank, Markt 62, B 2440 Geel, BELGIUM - code
IBAN: BE68 7333 0945 9534, SWIFT code: KREDBEBB) of Nieuwe
Media School, Geeploopweg 3, B 2400 Mol, BELGIUM. Mention:
name of the participant COURSE No BV-2006-016,
Code
of transfer: OUR.
Signature:
Please
send this reply slip to the course organiser as soon as possible,
by fax or e-mail:
fax+32-14-31
54 36
e-mail:
willy.aerts@skynet.be
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