Registration form
UBICOMM’07, SEMAPRO’07, ADVCOMP’07
Tahiti, French Polynesia [November 4-9, 2007]
(note: One registration allows a participant to assist to all conferences)
 
Please fill in the form, sign it, and send it via one of the following:
Fax: 1-302-475-6432
e-mail: oana@vicov.com 
mail: VICOV Event Expert LLC, P.O. BOX 8027, Wilmington DE 19803, USA
 
Title(Student/Prof/Dr): ______ First Name: _____________ Last Name: ___________________
Paper number generated by EDAS (e.g., #254): _______ (for authors only: only one paper per form) 
Paper conference (UBI/SEMA/ADV): _________     Institution: ____________________________
Street Address: ______________________________________________________________
City: __________________ State: ____________ Zip: ___________ Country: _____________
Phone: __________________ Fax: ___________________ Email : ______________________
This information may be sent later, using the registration form.
Arrival Date:        _______________ at ______________ with Flight N°: ________________
Departure Date:     ______________ at _______________with Flight N°: _________________
A. Conference Registration Fees
The full registration fees include: attendance to the conference, the coffee breaks, the gala dinner and the CD-proceedings for the conference where the paper is registered.
 	IEEE Member	Non-IEEE Member	 	
Academic Rate
IEEE Membership # ………………	550 €	600 €	______ €	
Industry rate
IEEE Membership #........................	750 €	800 €	______ €	
Late payment (after July 15/07, 100 €; after
August 15/07, 150 €)	                                                                               
   ______ €	
Additional Proceedings: 95 €	                                                                                 
 ______ €	
Extra pages: 100 € / page	
______ €	
Additional Gala Dinner: 90 €							     
 ______ €	
    TOTAL A: __________ €

B. Hotel special price (LIMITED TO THE FIRST 60 REGISTERED) 

Arrival date   __________Departure date _____________ Number of nights: ________
 
Hotel (these costs include room rate and taxes – taxes are usually around 10%)

Sofitel (one room for 1 or 2 persons; no breakfast, no lunch and no dinner)           140 € x ____nights  = ____
Sofitel (one room with breakfast and dinner for 1 person)                                       215 € x ____nights = _____
Sofitel (one room with breakfast and dinner for 2 persons)                                     290 € x ____nights = _____

Number of persons per room (One/Two)
Number beds (One/Two):
Bed for baby (Yes/No):    (___ years old)

TOTAL B: __________ €

C. Social event 
Moorea Daytour (full day with Lunch)             170  € x __  persons = _______ 

TOTAL C: __________ €

                                                       Total (A+B+C):       _________ €

Author’s signature: ___________________________ Date: _____________________

Payment of Fees: 
 
__ By Credit Card   (preferred method)            (____ Mastercard  or  ____Visa)          
 
Card number:    _________________________________________________________
Expiration date:  _________                                                                   
Holder's Name : ________________________
Holder’s Signature_______________________   Date:___________________
                                                                   
__ By Wire Transfer (please add 40 € for the wire transfer processing)
      Contact oana@vicov.com for the wire transfer accounts information 
      
Important: Please note that NO refund will be issued after July 15th , 2007