Registration form
ICN 2009 and ICONS 2009 and DBKDA 2009 

March 1-6, 2009 - Gosier, Guadeloupe  moved to Cancun, Mexico
(Note: One registration allows one 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: manuela@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 (e.g., #30254) (for authors only: only one paper per form) ________________

Paper conference (circle one):    ICN      ICONS       DBKDA

Institution: _________________________________________________________________

Street Address: ______________________________________________________________

City: __________________ State: ____________ Zip: ___________ Country: _____________

Phone: __________________ Fax: ___________________ Email: ______________________

This information may be sent later to manuela@vicov.com  

Arrival Date:        _______________ at ______________ with Flight N°: ________________

Departure Date:     ______________ at _______________with Flight N°: _________________
A. Conference Registration Fees
The full registration fees include: the welcome cocktail, attendance to all the conferences, 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 # ………………	565 €	615 €	______ €	
Industry rate
IEEE Membership #........................	765 €	815 €	______ €	
Late payment *
100 € | after November 26, 2008
150 € | after December 26, 2008
* late payment acceptable for attendance only, not for paper registration	                                                                               
   ______ €	
Additional Proceedings: 103 €/CD
ICN:… ICONS:…..  DB:….	                                                                                 
 ______ €	
Extra pages: 110 € / page	
______ €	
Additional Gala Dinner: 95 €							     
 ______ €	
    TOTAL A: __________ €
B. Tutorials 
Note: see final program
 
Tutorials are free of charge

C. Hotel special price (LIMITED TO THE FIRST 60 REGISTERED) 
(One hotel day starts at noon and ends at noon)

Arrival date   __________Departure date _____________ Number of nights: ________
 
Fiesta Americana Condesa Cancun (All taxes&services are included in the conference prices)

- Room for 1 person with 1 breakfast, no lunch and no dinner      175  € x ___nights  = ________
- Room for 2 persons with 2 breakfasts, no lunch and no dinner   200  € x ___nights  = ________
- Room for 1 person with 1 breakfast and 1 dinner)           210  € x ___nights  = ______________
 (Drinks are included)
- Room for 2 persons with 2 breakfasts and 2 dinners) 268  € x ___nights  = _________________
 (Drinks are included)

Number of persons per room (One/Two)
Number beds (One/Two):
Bed for baby (Yes/No):    (___ years old)
 
Shuttle Transfer: Airport/Conf Hotel/Airport            70  € x ____person(s)  = _______  

TOTAL C: __________ €

D. Social event 
(see Preliminary program)

Trip/Social Event (full day with Lunch)    120 € x __  person(s) = _______ 

Total (A+C+D):       _________ €
If wire transfer:                         40 €

TOTAL:    _____________________€

Payment of Fees (check one of the methods): 

__ By Credit Card   (preferred method)            (____ Mastercard or ____Visa)          
 
Card number:    _________________________________________________________
Expiration date:  _________                                                                   
Holder's Name: ________________________ Holder’s (hand) Signature: _________________
                                                                   
__ By Wire Transfer (please add 40 € for processing the wire transfer)
     Contact manuela@vicov.com for the wire transfer accounts information 
      
Date and Author’s Name: _____________________________
Author’s (hand) Signature: __________________________________

Important: Please note that NO refund on any service mentioned above will be issued after November 26th, 2008 as all the services are ordered and paid when the registration form is received and payment honoured.  
In case of an emergency that prevents the original presenter from attending, the registration may be transferred to another presenter.