ieee icia 2017 registration form regular

IEEE ICIA 2017 Conference Registration Form I. Personal Information Paper Number(s): / Family Name: Given Name: Preferred Title: Dr./Prof./Mr./Miss/Ms. Affiliation: Mailing Address: Country: E-mail: Mobile #: IEEE Membership Number: Student Number (student only): II. Registration Fees: Covering one copy of U-Disk Proceedings and access to banquet and all conference sessions & activities. Items Advance Registration by June 10, 2017 Regular Registration after June 10, 2017 Payment Amount A IEEE member: HK$4680 / US$600 / RMB￥4080 HK$5460 / US$700 / RMB￥4760 B Non-member: HK$5460 / US$700 / RMB￥4760 HK$6240 / US$800 / RMB￥5440 C IEEE student member: HK$3900 / US$500 / RMB￥3400 HK$4680 / US$600 / RMB￥4080 D Non-member student: HK$4680 / US$600 / RMB￥4080 HK$5460 / US$700 / RMB￥4760 E Extra proceedings: No. of extra U-Disk Proceedings _____ ✕ HK$390/US$50/RMB￥340 = F Extra page fee: No. of extra pages beyond 6 pages per paper_____ ✕HK$780/US$100/ RMB￥680 = G Extra paper fee: 2 nd paper (#________) of the same A or B author at HK$2340/US$300/ RMB￥2040 = H Extra banquet ticket: No. of extra banquet tickets ______ ✕HK$780/US$100/ RMB￥680 = I Exhibitor registration: HK$23,000/US$3,000/ RMB￥20,000 = Total registration and extra purchase payment amount (A or B or C or D or I) + E + F + G + H = III. Payment Options: The total payment calculated in item II above can be made in one of the following methods: 1. Credit Card Payment: Please use on-line payment via PayPal, Enter your PayPal account payer name: ___________________ 2. On-Line Registration Payment Completed via PayPal: q Enter your PayPal account payer name: ___________________ 3. Money Wire Transfer Payment: Please add the total registration payment calculated in item II and make wire transfer payment to HSBC Hong Kong Bank (Swift code: HSBCHKHHHKH), Des Voeux Road Central Branch, at the following address: China Insurance Group Building, 141 Des Voeux Road Central, Hong Kong, with Account Number = 400-407433-838 and account holder = Super Elite Events Limited and then email your payment proof and your completed registration form to the conference secretariat email at the bottom of this page by June 10, 2017 to take advantage of the advance registration fee rates. Please indicate IEEE ICIA 2017, the name of the 1 st author of the paper, and the paper number(s) on the bank wire transfer payment document. IV. Important Information: ü Each final paper submission must be accompanied by a paid registration for inclusion in the conference program & proceedings. ü Each regular or student registration (A, B, C, or D above) covers one paper of the same author who has paid for the registration. ü Each author who paid for the regular registration (A or B) can cover one more paper of the same author via extra 2 nd paper fee. ü Each student registration (C or D) must be accompanied by proof of current full-time student status via student ID or a letter. ü Completed registration form with registration payment proof, and student status proof if applicable must be sent via email to the conference secretariat at [email protected] to complete your conference registration. ü For any questions about IEEE ICIA 2017 conference & conference registration, please contact the conference secretariat at: E-mail: [email protected]; Tel: +86 13713500061 PayPal on-line payment web link: Please click on “Registration” at the conference website: http://2017.ieee-icia.org

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Page 1: IEEE ICIA 2017 Registration Form Regular

IEEEICIA2017ConferenceRegistrationFormI.PersonalInformation

PaperNumber(s): / FamilyName: GivenName: Preferred Title: Dr./Prof./Mr./Miss/Ms. Affiliation: MailingAddress:

Country: E-mail: Mobile#:

IEEE Membership Number: StudentNumber(studentonly):

II.RegistrationFees:CoveringonecopyofU-DiskProceedingsandaccesstobanquetandallconferencesessions&activities. Items AdvanceRegistrationbyJune10,2017 RegularRegistrationafterJune10,2017 PaymentAmount

A IEEEmember: HK$4680/US$600/RMB￥4080 HK$5460/US$700/RMB￥4760

B Non-member: HK$5460/US$700/RMB￥4760 HK$6240/US$800/RMB￥5440

C IEEEstudentmember: HK$3900/US$500/RMB￥3400 HK$4680/US$600/RMB￥4080

D Non-memberstudent: HK$4680/US$600/RMB￥4080 HK$5460/US$700/RMB￥4760

E Extraproceedings: No.ofextraU-DiskProceedings_____✕HK$390/US$50/RMB￥340=

F Extrapagefee: No.ofextrapagesbeyond6pagesperpaper_____✕HK$780/US$100/RMB￥680=

G Extrapaperfee: 2ndpaper(#________)ofthesameAorBauthoratHK$2340/US$300/RMB￥2040=

H Extrabanquetticket: No.ofextrabanquettickets______✕HK$780/US$100/RMB￥680=

I Exhibitorregistration: HK$23,000/US$3,000/RMB￥20,000=

Totalregistrationandextrapurchasepaymentamount(AorBorCorDorI)+E+F+G+H=

III.PaymentOptions:ThetotalpaymentcalculatedinitemIIabovecanbemadeinoneofthefollowingmethods:

1.CreditCardPayment:Pleaseuseon-linepaymentviaPayPal,EnteryourPayPalaccountpayername:___________________

2.On-LineRegistrationPaymentCompletedviaPayPal: q EnteryourPayPalaccountpayername:___________________

3. Money Wire Transfer Payment: Please add the total registration payment calculated in item II and makewire transferpayment toHSBCHongKongBank (Swift code:HSBCHKHHHKH),DesVoeuxRoadCentral Branch,at the following address:China Insurance Group Building, 141 Des Voeux Road Central, Hong Kong, with Account Number = 400-407433-838 andaccountholder=SuperEliteEventsLimitedandthenemailyourpaymentproofandyourcompletedregistrationformtotheconferencesecretariatemailatthebottomofthispagebyJune10,2017totakeadvantageoftheadvanceregistrationfeerates.PleaseindicateIEEEICIA2017,thenameofthe1stauthorofthepaper,andthepapernumber(s)onthebankwiretransferpaymentdocument.

IV.ImportantInformation:ü Eachfinalpapersubmissionmustbeaccompaniedbyapaidregistrationforinclusionintheconferenceprogram&proceedings.ü Eachregularorstudentregistration(A,B,C,orDabove)coversonepaperofthesameauthorwhohaspaidfortheregistration.ü Eachauthorwhopaidfortheregularregistration(AorB)cancoveronemorepaperofthesameauthorviaextra2ndpaperfee.ü Eachstudentregistration(CorD)mustbeaccompaniedbyproofofcurrentfull-timestudentstatusviastudentIDoraletter.ü Completedregistrationformwithregistrationpaymentproof,andstudentstatusproofifapplicablemustbesentviaemailtothe

[email protected] completeyourconferenceregistration.ü ForanyquestionsaboutIEEEICIA2017conference&conferenceregistration,pleasecontacttheconferencesecretariatat:

E-mail:[email protected];Tel:+8613713500061PayPalon-linepaymentweblink:Pleaseclickon“Registration”attheconferencewebsite:http://2017.ieee-icia.org

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