Registration form
SEMAPRO 2009

October 11-16, 2009, Sliema, Malta 
(One registration allows one participant to assist to all the events in NexTech 2009)
 
Please fill in the form, sign it by hand, and send it via one of the following:
Fax: 1-302-475-6432
E-mail: andrea@vicov.com 

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

Paper number (e.g., #254) (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 CD-proceedings for the conference where the paper is registered (including IEEE Xplore Publication), and the participation to all the scientific events.
 	IEEE Member	Non-IEEE Member	 	
Academic Rate
IEEE Membership # ………………	565 €	615 €	______ €	
Industry rate
IEEE Membership #........................	765 €	815 €	______ €	
Late payment *
- after July 15/2009, 100 €
- after August 15/2009, 150 €
* late payment acceptable for attendance only, not for paper registration	                                                                               
   ______ €	
Additional Proceedings: 100 €/CD	                                                                                 
   ______ €	
Extra pages: 105 € / 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) 
Arrival date   ____________		Arrival time _____________
Departure date _____________ 	Departure time _____________
Number of nights: ________
Note: a hotel day starts at noon
 
The Palace Malta (All taxes are included in conference prices)
Note: The initially posted prices have been re-negotiated with the hotel and lower prices are now posted:

- Deluxe Room for 1 person with 1 breakfast, no lunch and no dinner      120  € x ___nights  = _______
- Deluxe Room for 2 persons with 2 breakfasts, no lunch and no dinner   140  € x ___nights  = _______

Total C: __________ €

D. Social event [October 16, 2009]
(See Preliminary Program)

Visit of Valetta + Mdina ++ (full day with lunch)                      110 € x __ person(s) = _______ €

If ‘credit card”:                                      TOTAL (A + C + D):       _________ €
If “wire transfer”:			     TOTAL (A + C + 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 andrea@vicov.com for the wire transfer accounts information 
      
Date and Author’s Signature: ________________________________

Important: Please note that NO refund on any service mentioned above will be issued after July 15th, 2009 as all the services are ordered and paid when the registration is received. 
In case of an emergency that prevents the original presenter from attending, the registration may be transferred to another presenter.