The European Day of Speech and Language Therapy
Date: 8th March 2013
National Curriculum Centre, Ħamrun
REGISTRATION FORM
Name :………………………………………………………………………………………
Profession/Parent : ………………………………………………………………………..
Name of child: …………………………………… Age ………………………………..
Name of child: …………………………………… Age ………………………………..
Preferred language (kindly tick):
□ Malti
Preferred time of session:
□ 4.00pm
□ English
□ Both
□ 5.30pm
Contact Details
Address: ................................................................................................................................................................
Post Code:…………….
Email: ……………………………………………………...
Mobile Number: ……………………………………… Tel Number:……………………………………………………
The whole session, of approximately one hour, comprises of:
 30 minutes information session on what is Specific Language Impairment and practical advice
 60 minutes activity for children with parents/adults joining children for last 30 minutes
Refreshments will be available and there will also be information stands by various sponsors.
Payment: Donation of €5 (Please make cheques payable to: Association of Speech Language
Pathologists if sending in application by post or pay at the door if application is sent by email).
Applications and payments need to be sent to:
The Treasurer, Association of Speech-Language Pathologists, Federation of Professional Bodies, The
Professional Centre, Sliema Road, Gżira GŻR 1633, Malta.
Or by email on info@aslpmalta.org
or by phone on 21312888 (9:00 a.m. – 2:00 p.m.)
By not later than the 5th March 2013.
Booking is highly recommended for logistic purposes and so as not to be disappointed!
Signature:…………………………………………
Date:………………………