Conferência Internacional para a Inclusão (INCLUDiT 2023)

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1. Personal Information

Name *

(Please insert your full name according to your identification card.)

Address *

Zip Code *

City *

Phone Number *

TAX Number *

(If non-Portuguese Tax Number, please fill in with 999999990)

Country *

Affiliation

(Please enter the designation of the company or institution where you develop your professional activity.)

Profession/Job Title/Function

E-mail address *

(Please insert your email address. The address introduced will be used for future communications)

2. Invoice Information

Please fill in the fields below if you require the invoice in a different name from above-mentioned.

Receipt in

Name

Address

Postal/Zip Code

City

Country

TAX Number

Phone Number

Fax

3. Registration - Conference fees

Price

TOTAL: 0.00 €

NOTE: the cancellation of subscriptions implies the total loss of the amount of the registration fee, there is no place the refunds

4. Additional Information

If you are the author of an abstract, please indicate the code of the manuscript

Presentation modality *

Online (access only to the parallel session where the paper will be presented)

In-person (offer of the printed books of the previous edition of INCLUDiT, access to all activities of the event)

If applicable, select the access option(s) you require

Braille

Enlarged text

IS - International Signal System

Other

Please specify *

5. Payment Method

Credit Card

Morada IPLeiria:

Rua General Norton de Matos

Apartado 4133

2411-901 Leiria

Portugal

Política de Privacidade | Política de Reembolso

Note: After you select the credit card payment method and submit the application form, you will receive an email for credit card payment instructions.

Bank Transfer

Payment by Bank Transfer to:
Instituto Politécnico de Leiria
R. General Norton de Matos
Apartado 4133
2411-901 Leiria

Bank Name:
Instituto de Gestão da tesouraria e do Crédito Publico, IP
Avenida da República, N.º 57, 6º
Place: Lisboa
Postal/Zip Code: 1050-189
Country: Portugal
NIF: 503 756 237
Phone: +351 217 923 300
FAX: +351 217 993 795

NIB: 078101120000000133640
IBAN: PT50078101120000000133640
SWIFT BIC CODE: IGCPPTPL

For bank transfers, the description of the transfer must comply with the following format: "INCLUDIT23+Registration Number".

A copy of the payment/transfer should be sent by email to adelaide.ferreira@ipleiria.pt.

6. Data Protection

Information

1.1. within the framework of the activities that develops, the Leiria Polytechnic shall register images, for use in educational and scientific purposes conducted by the Institute and its organic units, by your dissemination by the academic community, within the context of schools, as well as for creation of file.

1.2. In the framework of the activities that develops, the Leiria Polytechnic proceeds, sometimes, the disclosure of these activities in the electronic pages, social network and media.

1.3. At any time, you have the right to access your personal data and, within the limits of the law, of the change, oppose the respective treatment, deciding about the automated treatment of the same, withdraw the consent and the other rights. Remove your consent, if such does not compromise the lawfulness of the processing done by that date.

1.4. Have the right to be notified, pursuant to the legislation, in the event of a breach of their personal data and may submit claims before the authority or authorities.

1.5. for more information, please see the privacy policy and personal data of the Politécnico de Leiria

Consent

I give my consent to the Instituto Politécnico de Leiria to treat my personal data for the purposes of disclosure of future events, courses and other IPLeiria actions carried out in this area.

To continue with my application I give my consent to that, in the course of my participation in this activity, may be collected images that involve me, individually or in a group, which may be disclosed in the context of the event, on pages Electronics, social network and media.

7. Submit Registration

I declare that all informations provided on this Application Form are true without any omission to the same. *