The International Association of Laryngectomees

 

IAL Voice Institute Registration

Standard Mail-in Registration:
If you would like to print the registration, fill it out and and mail it
instead of using the online form, you can download it here
IAL Voice Institute Registration PDF


Online Registration:
This form should be used if you are a laryngectomee and would like assistance to develop or improve your speech, register for the IAL Voice Institute as a Voice Institute Pupil (VIP) on the form below.

This form should be used if you have been a laryngectomee for at least two years, have good speaking skills, and would like in-depth instruction in communication methods and related topics to serve as a peer-counselor to other laryngectomees, register for the IAL Voice Institute as a Laryngectomee Trainee (LT) on the form below.

All others, please register for the Annual Meeting using the alternate form for the Annual Meeting.

Registration Fee:
Description   After August 1, 2008 On or Before August 1, 2008
Voice Institute Pupil (VIP)   $95.00 $80.00 (limited scholarships available)
Laryngectomized Trainee (LT)   $95.00 $80.00 (limited scholarships available)
Speech Pathology Trainee (ST)   $425.00 $400.00
Graduate Student (GS)   $165.00 $150.00

Note:
Spouses/partners may not register for the Voice Institute. If attending as observers, they must register with the IAL Annual Meeting (see IAL Annual Meeting Registration form on page 16).
There are a very limited number of scholarships available for SLPs who require financial assistance to attend. For further information, contact:

Interim Voice Institute Director, Dr. Jeff Searl, at (913) 588-5937 (cell), or at jsearl@kumc.edu

There are a limited number of Batten Scholarships available for laryngectomees who require financial assistance to attend. To apply for eligibility please visit this page or contact:


Caryn F. Melvin PhD., Dorn VA Medical Center, Speech Pathology (126)
6439 Garners Ferry Rd., Columbia, SC 29209
carynmelvin@gmail.com - Tel:(803) 776-4000 ext 6458 - Fax:(803) 695-7908

Number of people attending?
  1 Person   2 People
Attendee 1
Attendee 2
Voice Institute Pupil (VIP)
Voice Institute Pupil (VIP)
Laryngectomized Trainee (LT)
Laryngectomized Trainee (LT)
Speech Pathology Trainee (ST)
Speech Pathology Trainee (ST)
Graduate Student (GS)
Graduate Student (GS)
Personal Information
Laryngectomee?
Attendee 1: First name
   Last name
Yes
   
No
   
Attendee 2: First name
   Last name
Yes
   
No
   
Street Address:    
Professional Address:    
Institution/Facility Address:    
City: State: Zip:    
    Country:    
Phone #: - - Email:    

Special needs and Personal Information displayed in the Attendee list
Check here if you decline to have your address, phone, or e-mail displayed on the attendee list?
 
Check here if you require assistance or special accommodations to attend meeting because of physical limitations. You will be contacted for further information.

If there is anything else you would like to share with the IAL, please feel free to add it here
Additional Comments:

 

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