IEEE CogSIMA 2015 9-12 March 2015
IEEE CogSIMA 2015 9-12 March 2015 Orlando, Florida, USA Registrant Information (Please print clearly)
*INDICATES REQUIRED FIELDS THAT MUST BE COMPLETED
*Last/Family/Surname
*First/Personal Name
*Company, University or Other Affiliation
*Job Title
*Address
P.O. Box / Mail Stop
*City
US State/Canadian Province
*Primary Contact Number
*Zip/Postal Code Fax Number
*Country Mobile Phone
Emergency Contact Name
Contact Number
IEEE or COMSOC Membership Number
*Email Address (for confirmation purposes)
Members of IEEE and the following ComSoc Sister Societies may register at the IEEE Member Rate (circle all applicable): ACS AEAI AICA AICT AIU CCIS CIC CIE CIEE CMAI CoE EWI EZS FITCE FRUCT HTE IEICE-CS IEM IETE IIC KICS LIKTA MAEECE POPOV PTC REV SAIEE SBrT SCS SEE Please check this box if you have any special needs or dietary restrictions. We will contact you if necessary. Please indicate what they are ______________________________________________________
What is your reason for attending CogSIMA 2015? (Please check all that apply) Education Network with others Present at paper/poster/demo Other _______________________
Organizational Status: (Check all that apply) Industry Government Academia Other: _____________________
*How did you hear about CogSIMA? IEEE CogSIMA 2015 Web site CFP Announcement IEEE Communications Magazine Colleague Social Media Other _______________________
*Please indicate if you will be attending the off site banquet? The banquet is included. Yes No
AUTHOR POLICY: The author registration deadline is 9 February 2015. PLEASE NOTE: To be published in the IEEE CogSIMA Conference Proceedings and IEEE Xplore®, an author of an accepted paper is required to register for the conference at the full (member or non-member) rate and the paper must be presented by an author of that paper at the conference unless the TPC Chair grants permission for a substitute presenter in advance. Authors cannot register at a student rate. Non-refundable registration fees must be paid prior to uploading the final IEEE formatted, publication-ready version of the paper. Accepted and presented papers will be published in the IEEE CogSIMA 2015 Conference Proceedings and submitted to IEEE Xplore®. One author can present three (3) papers with one registration. ATTENDEE REGISTERATION ComSoc Member IEEE Member1 Non-Member2 IEEE Life Member IEEE Student Member (FULL TIME STUDENTS ONLY) Student Non Member (FULL TIME STUDENTS ONLY)
ON/BY 9 February US$600 US$625 US$750 US$50 US$150 US$175
AFTER 9 February US$675 US$700 US$825 US$50 US$225 US$250
Registration Includes: Welcome Reception, USB Flash Drive Proceedings, Conference Banquet and coffee breaks. 1. Includes complimentary IEEE ComSoc membership (digital delivery of IEEE Communications Magazine) 2. Includes complimentary affiliate ComSoc membership (digital delivery of IEEE Communications Magazine) TUTORIALS T1: T2 T3: T4 TUTORIAL REGISTERATION ComSoc Member IEEE Member1 Non-Member2 IEEE Life Member IEEE Student Member (FULL TIME STUDENTS ONLY) Student Non Member (FULL TIME STUDENTS ONLY)
ADDITIONAL ITEMS Qty ____ Guest Banquet Ticket (US$70)
ON/BY 9 February US$125 US$150 US$175 US$50 US$75 US$100
Qty ____Additional Proceedings (US$25)
AFTER 9 February US$150 US$175 US$200 US$50 US$75 US$100
Registration
Additional Item
Tutorials
US$____________
US$______________
US$_____________
TOTAL US$___________________ ATTENDEE NAME: ______________________________________________
VISA ASSISTANCE LETTERS: Non‐Authors (Speakers, Committee Members, and paid attendees) requiring visa assistance letters or authors needing a hard copy of the letter must complete a ComSoc Visa Assistance Request (http://www.comsoc.org/node/add/visa-assistance-request). Authors should go EDAS to retrieve their personalized visa assistance letters (soft copy in PDF format). CANCELLATION POLICY: All refund/cancellation requests must be provided via email to [email protected] and received by 21 February 2015. No refunds will be provided after this date. There will be a US $100 administrative fee deducted from each refund.
REGISTRATION PAYMENT CHECK Issued in US Dollars (Payable to: IEEE CogSIMA 2015) Visa MasterCard Wire Transfer fee US$20. Please email [email protected] for instructions.
American Express
Discover
Card Number ___________________________________________________________ Expiration Date ______________________CVV _________ Name on Card ___________________________________________________Authorized Signature ______________________________________
Mail/Fax/E‐mail Completed Registration Form & Payment To: IEEE/MCM: ________, Conference Planner 445 Hoes Lane, Piscataway, New Jersey 08855 USA Fax: +1 732 465 6447 E‐mail: [email protected] Non-discrimination: "IEEE is committed to the principle that all persons shall have equal access to programs, facilities, services, and employment without regard to personal characteristics not related to ability, performance, or qualifications as determined by IEEE policy and/or applicable laws. For more information on the IEEE policy visit http://www.ieee.org/nondiscrimination IEEE may use the information you provide us to contact you from time to time concerning similar IEEE conferences, technical products and services or to ask your opinions. If you do not want us to contact you please check here:
*INDICATES REQUIRED FIELDS THAT MUST BE COMPLETED
*Last/Family/Surname
*First/Personal Name
*Company, University or Other Affiliation
*Job Title
*Address
P.O. Box / Mail Stop
*City
US State/Canadian Province
*Primary Contact Number
*Zip/Postal Code Fax Number
*Country Mobile Phone
Emergency Contact Name
Contact Number
IEEE or COMSOC Membership Number
*Email Address (for confirmation purposes)
Members of IEEE and the following ComSoc Sister Societies may register at the IEEE Member Rate (circle all applicable): ACS AEAI AICA AICT AIU CCIS CIC CIE CIEE CMAI CoE EWI EZS FITCE FRUCT HTE IEICE-CS IEM IETE IIC KICS LIKTA MAEECE POPOV PTC REV SAIEE SBrT SCS SEE Please check this box if you have any special needs or dietary restrictions. We will contact you if necessary. Please indicate what they are ______________________________________________________
What is your reason for attending CogSIMA 2015? (Please check all that apply) Education Network with others Present at paper/poster/demo Other _______________________
Organizational Status: (Check all that apply) Industry Government Academia Other: _____________________
*How did you hear about CogSIMA? IEEE CogSIMA 2015 Web site CFP Announcement IEEE Communications Magazine Colleague Social Media Other _______________________
*Please indicate if you will be attending the off site banquet? The banquet is included. Yes No
AUTHOR POLICY: The author registration deadline is 9 February 2015. PLEASE NOTE: To be published in the IEEE CogSIMA Conference Proceedings and IEEE Xplore®, an author of an accepted paper is required to register for the conference at the full (member or non-member) rate and the paper must be presented by an author of that paper at the conference unless the TPC Chair grants permission for a substitute presenter in advance. Authors cannot register at a student rate. Non-refundable registration fees must be paid prior to uploading the final IEEE formatted, publication-ready version of the paper. Accepted and presented papers will be published in the IEEE CogSIMA 2015 Conference Proceedings and submitted to IEEE Xplore®. One author can present three (3) papers with one registration. ATTENDEE REGISTERATION ComSoc Member IEEE Member1 Non-Member2 IEEE Life Member IEEE Student Member (FULL TIME STUDENTS ONLY) Student Non Member (FULL TIME STUDENTS ONLY)
ON/BY 9 February US$600 US$625 US$750 US$50 US$150 US$175
AFTER 9 February US$675 US$700 US$825 US$50 US$225 US$250
Registration Includes: Welcome Reception, USB Flash Drive Proceedings, Conference Banquet and coffee breaks. 1. Includes complimentary IEEE ComSoc membership (digital delivery of IEEE Communications Magazine) 2. Includes complimentary affiliate ComSoc membership (digital delivery of IEEE Communications Magazine) TUTORIALS T1: T2 T3: T4 TUTORIAL REGISTERATION ComSoc Member IEEE Member1 Non-Member2 IEEE Life Member IEEE Student Member (FULL TIME STUDENTS ONLY) Student Non Member (FULL TIME STUDENTS ONLY)
ADDITIONAL ITEMS Qty ____ Guest Banquet Ticket (US$70)
ON/BY 9 February US$125 US$150 US$175 US$50 US$75 US$100
Qty ____Additional Proceedings (US$25)
AFTER 9 February US$150 US$175 US$200 US$50 US$75 US$100
Registration
Additional Item
Tutorials
US$____________
US$______________
US$_____________
TOTAL US$___________________ ATTENDEE NAME: ______________________________________________
VISA ASSISTANCE LETTERS: Non‐Authors (Speakers, Committee Members, and paid attendees) requiring visa assistance letters or authors needing a hard copy of the letter must complete a ComSoc Visa Assistance Request (http://www.comsoc.org/node/add/visa-assistance-request). Authors should go EDAS to retrieve their personalized visa assistance letters (soft copy in PDF format). CANCELLATION POLICY: All refund/cancellation requests must be provided via email to [email protected] and received by 21 February 2015. No refunds will be provided after this date. There will be a US $100 administrative fee deducted from each refund.
REGISTRATION PAYMENT CHECK Issued in US Dollars (Payable to: IEEE CogSIMA 2015) Visa MasterCard Wire Transfer fee US$20. Please email [email protected] for instructions.
American Express
Discover
Card Number ___________________________________________________________ Expiration Date ______________________CVV _________ Name on Card ___________________________________________________Authorized Signature ______________________________________
Mail/Fax/E‐mail Completed Registration Form & Payment To: IEEE/MCM: ________, Conference Planner 445 Hoes Lane, Piscataway, New Jersey 08855 USA Fax: +1 732 465 6447 E‐mail: [email protected] Non-discrimination: "IEEE is committed to the principle that all persons shall have equal access to programs, facilities, services, and employment without regard to personal characteristics not related to ability, performance, or qualifications as determined by IEEE policy and/or applicable laws. For more information on the IEEE policy visit http://www.ieee.org/nondiscrimination IEEE may use the information you provide us to contact you from time to time concerning similar IEEE conferences, technical products and services or to ask your opinions. If you do not want us to contact you please check here:
