IEEE-ROBIO2011.docVIP

IEEE-ROBIO 2011 The M?venpick Resort and Spa Karon Beach, Phuket, Thailand, December 7-11, 2011 REGISTRATION FORM Delegate Information Please complete in BLOCK CAPITALS Title please tick √ : ? Prof. ?Dr. ? Mr. ? Mrs. ? Ms. Surname: ______________________________________ Given Name: _____________________________________ Department: __________________________________ Position: _______________________________________ Company / Institution: ___________________________________________________________________________ Unit / Street: ___________________________________ City: ____________________________________________ State / Province: _______________________________ Postal Code: ____________________________________ Country: _____________________________________ Telephone: ______________________________________ Fax: ________________________________________ E-mail: _________________________________________ Registration Fees The exchange rate is approximately USD1 HKD 7.8 Early Registration On/Before Oct 25, 2011 Late Registration After Oct 26, 2011 IEEE Member Membership No: _____________________ HKD 4,290 USD 550 HKD 5,070 USD 650 Non-IEEE Member HKD 4,680 USD 600 HKD 5,460 USD 700 IEEE Student Member Membership No: _____________________ HKD 3,315 USD 425 HKD 3,900 USD 500 Non-IEEE Student Member HKD 3,705 USD 475 HKD 4,290 USD 550 Subtotal 1 : HKD The registration fee covers the following: One non-student registration covers a maximum of two accepted papers by the same registered author. A student registration may only cover ONE accepted paper. An additional US$300 must be paid by the same author for each additional paper to be included in the proceedings if the additional paper s have no other registered authors. 1 Conference bag, 1 CD Proceedings, 1 reception ticket, and 1 banquet ticket. Drinks and food served at the tea-breaks are also free to all registered attendees. Additional lunch tickets MAY also be provide