last updated 7/14/2020


Dabrowski Congress

14th INTERNATIONAL DABROWSKI CONGRESS 

August 12 – 14, 2021


GCP Conference Campus

Exploring the Theory of Positive Disintegration


Registration Form

Instructions:
You may register for the Dabrowski Congress in a few ways:

  • To pay by credit card, click here

     
  • By mail – send this form along with a check payable to Gifted Conference Planners to the address below. Please fill in all relevant blanks for each attendee. If you wish to include notes or special instructions, please use a separate sheet or the back of the page. Gifted Conference Planners, c/o 7 North End Rd., Townsend, MA 01469-1124
  • By waiver - we will waive the registration fee for anybody who cannot afford it upon request.



Category
Intro to TPD Workshop only Conference (including Intro)

 
 Thursday only

Thursday through Saturday
Registration

 Each Adult (up to 3)
$5 $10

 More than 3 Adults
$20 $35

 Students (up to 3)
Free $5
  More than 3 students Still free$20 

Check your cart:  



If you have questions, you can reach us by email or leave a message at 1-978-300-5432.
*************************
General Information:
Name:
Street Address:
City: _________________State/Province: ______Postal Code: ____________
Country: ______________Phone Number: _____________Fax: ______________
Email: ______________________Institution (if any): ________________________
Total Fees: $_____.00 + Donation (optional): $______ = Total Amount Enclosed: $________
I am registering a family and would like apply the discount:
Reminder: Checks should be made payable to Gifted Conference Planners.

Attendee Information:
Number of Attendees: ___ (Include additional copies of the third page as needed.)

Attendee 1:
Name:
__________________________
Group: Adult ___ Student ___
Email (if
different): __________________________
Institution:
Sessions Attending:
Thursday ___ Friday ___ Saturday ___
Please tell us your primary role(s):
Educator ___ Therapist ___ Researcher ___ Student ___ Parent ___
Fees: $______ 


Attendee 2:
Name:

__________________________
Group: Adult ___ Student ___
Email (if
different): __________________________
Institution:
Sessions Attending:
Thursday ___ Friday ___ Saturday ___
Please tell us your primary role(s):
Educator ___ Therapist ___ Researcher ___ Student ___ Parent ___
Fees: $______ 


Attendee 3:
Name:
__________________________
Group: Adult ___ Student ___
Email (if
different): __________________________
Institution:
Sessions Attending:
Thursday ___ Friday ___ Saturday ___
Please tell us your primary role(s):
Educator ___ Therapist ___ Researcher ___ Student ___ Parent ___
Fees: $______ 


Attendee 4:
Name:
__________________________
Group: Adult ___ Student ___
Email (if
different): __________________________
Institution:
Sessions Attending:
Thursday ___ Friday ___ Saturday ___
Please tell us your primary role(s):
Educator ___ Therapist ___ Researcher ___ Student ___ Parent ___
Fees: $______ 

#prices and details subject to change without notice


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