last updated 7/21/2019

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14th INTERNATIONAL DABROWSKI CONGRESS 

Boxborough, Massachusetts
August 6 – 8, 2020

Boxboro Regency Hotel and Conference Center, Boxborough, MA

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, tally your amount, then click here. (Individual item buttons will be added later.) 
   
• 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
• In person – while we prefer advance registration, walk-ins are welcome (prices will rise).

Discounts!! Members of the Massachusetts Association for Gifted Education (MAGE), New Hampshire Association for Gifted Education (NHAGE), or Gifted Homeschoolers Forum (GHF) are eligible for discounts: $25 for the first (2 day) adult.

These rates will go up starting September 1, 2019.

	Category		Intro to TPD Workshop	Conference 2	Conference 1
			Thursday (with lunch) ($10/person discount  Reg. if attending all 3 days)	Two Day Registration (Fri. & Sat.)	One Day Registration (Fri. or Sat.)
	1st Adult		$65	$180	$80
	2nd Adult		$65	$100	$55
	4 to 6 Adults		$250	XXX	XXX
	7 or more adults		$40 each	XXX	XXX
	1st Student*		$35	$100	$55
	2nd Student*		$30	$75	$40

Check your cart:  

*IDs of Students may be checked on the day of the conference (but don't bet on it).

If you have questions, you can reach us by email or leave a message at 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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