Registration ATC 2020

Main details

Salutation *	Mr.Mrs.Ms.Dr.Prof.PhD
First name *
Surname *
Email *
Work - organisation *
Position *
Other affiliations
Street *
Number *
Postal/ZIPcode *
City *
Country *
Phone *
VAT number
I get a discount because I am *	Unfortunately, I have no right UFC-partner of the Flemish cooperation agreement (psychosocial teams in prison, probation officers (justitiehuizen), specialized treatment services) A student Member of NL-ATSA or ATSA A VVKP member
My registration is part of a group registration (min. 5 colleagues of the same department) * For those registering with min. 5 colleagues from the same instancy. Note that the head of the department needs to submit a signed request before registering with the names of all attending colleagues.
	Yes No

Registration conference

(Prices between brackets are discounts)

	EARLY BIRD	AFTER 07.01.2020
Registration 1 day	€ 130 (€ 110)	€ 150
Registration 2 days	€ 220 (€ 200)	€ 240
Registration 1 day preconference workshop	€ 90	€ 90
Registration 2 days preconference workshop	€ 180	€ 180

Registration conference *
No registration for the 2-day conference, registering only for the workshop
Registration 1 day early bird - 06/02 € 130 (discount € 110)
Registration 1 day early bird - 07/02 € 130 (discount € 110)
Registration 2 days early bird - 06/02 and 07/02 € 220 (discount € 200)
Registration 1 day (after 07.01.2020) - 06/02 - ONE PRICE, no discounts! € 150
Registration 1 day (after 07.01.2020) - 07/02 - ONE PRICE, no discounts! € 150
Registration 2 days (after 07.01.2020) - 06/02 and 07/02 - ONE PRICE, no discounts! € 240

Registration workshops *
No registration for the workshops, only for the conference Registration 1 day preconference workshop - Treatment - ONE PRICE, no discounts! € 90 (available 54/70) Registration 2 day preconference workshop - SSA training - Risk assessment (in Dutch) - ONE PRICE, no discounts! € 180 (available 6/40)

Registration for the reception (Thursday 06.02.2020, 5pm-6.30pm) – For free! *
Yes
No
Registration for the conference dinner (incl. dinner & beverages) - Restaurant aan de Stroom - (Thursday 06.02.2020, 7pm-…) – €55 *
Yes
No
Indicate if you have any allergies or special needs

Total amount due: €

Payment options * Bank transfer
Credit card via Ogone
Your registration is only complete after payment of the indicated amount.

When your registration form is submitted, you will receive a confirmation of your registration.

* required fields

The conference organization, (contact: Minne De Boeck, minne.deboeck@uza.be) collects this personal data for the organization of congress 'At the Crossroads 2.0.'. Under no circumstances will these data be passed on to third parties. This information is kept up to date until after the event. If you wish to view, limit, change or remove your personal data, please contact us at the address mentioned above. More information about our privacy policy: www.uantwerpen.be/disclaimer.