Registration Form
MMEDIA 2013
April 21 - 26, 2013 - Venice, Italy
 (One registration allows one participant to assist to all NexComm 2013)
 
Please fill in the form, sign it by hand, and send it via one of the following:
Fax: 1-302-397-2096           E-mail: annemarie@vicov.com

Title (Student/Prof/Dr): ____First Name: _______________ Last Name: ______________

Paper number (e.g., #10254) (for authors only: only one paper per form) ______________

Institution: _______________________________________________________________

Street Address: ___________________________________________________________

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

Phone: __________________ Fax: ___________________ Email: __________________

A. Conference Registration Fees
The full registration fees include: access to all the conferences, the welcome cocktail, the coffee breaks, the gala dinner, the digital proceedings (including archiving, publication, and indexing), and the participation to all the scientific events under NexComm 2013.

 	IARIA Fellows or Full Time Students	Academic	Industry		
Registration	565 €	615 €	815 €	
______ €	
Additional late fee *
- after February 12 / 2013, 100 €
- after March 12 / 2013, 150 €
* late payment acceptable for attendance only
* authors must register at latest on February 12, 2013	                                                                               

   ______ €	
Extra pages: 105 € / page (over  6 pages) 		
______ €	
Additional Gala Dinner: 95 €							     
	
______ €	

    TOTAL A: __________ €

B. Tutorials 
Note: see final program
 Tutorials are free of charge for all the attendees

C. Hotel 

Conference takes place at:
NOVOTEL VENEZIA MESTRE CASTELLANA
Via Ceccherini 21
30174 VENEZIA MESTRE
ITALY

A group registration form directly with hotel is available at:
http://www.iaria.org/conferences2013/filesMMEDIA13/reservation.pdf

Feel free to arrange your stay in Venice however it is more convenient for you. Note that depending on where you book (direct, online, travel agency, etc.), prices may differ.

- You can also directly book hotel on your own:
http://www.novotel.com/gb/hotel-3307-novotel-venezia-mestre-castellana/index.shtml

- You can also book a room at nearby hotels online or via your travel agency.

D. Social Event - Tour [April 26, 2013]

One day trip in Venice (see the preliminary program for details) 	157 € x __  persons = _____€
If ‘credit card”:                                  	  	  TOTAL (A + D): 	_________ €
If “wire transfer”:				     TOTAL (A + D + 40€):	__________€
Payment of Fees (check one of the methods): 

__ By Credit Card   (preferred method)            (____ Mastercard or ____Visa)          
 
Card number:    _________________________________________________________
CVV:  _________________ (this is the 3 or 4 digit number on the back of the card)
Expiration date:  ___________                                                                   
Holder's Name: ________________________ Holder’s Signature: _________________

Credit Card billing address:
Street address:________________________________________________________
City: _______________________________ State: ___________________________
Zipcode/Postcode _____________________ Country: ________________________
                                                                   
__ By Wire Transfer (please add 40 € for processing the wire transfer)
     Contact annemarie@vicov.com for the wire transfer accounts information

In case of extraordinary situation, as deemed by IARIA, you allow the publisher to act on the authors' behalf with respect to camera ready upload step and the copyright release step.

Date and Author’s Signature: ___________________________________________

Note: While registration fees are quoted in Euro € as a standard currency, fees will be charged in U.S. Dollars $ at the official rate on the date the payment is processed.

Important: Please, note that NO refund on any service mentioned above will be issued after February 12, 2013 as all the services are ordered and paid when the registration is received. No refunds are possible after the reviews are released. In case of an emergency that prevents the original presenter from attending, the registration may be transferred to another presenter.