Registration form
AP2PS 2010

October 25-30, 2010, Florence, Italy 
(One registration allows one participant to assist to all NexTech 2010 events)
 
Please fill in the form, sign it by hand, and send it via one of the following:
Fax: 1-302-397-2096
E-mail: andrea@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 CD-proceedings for the conference where the paper is registered (including archiving, publication, and indexing), and the participation to all the scientific events under the NexTech 2010 umbrella. 
 	IEEE Member
IARIA Fellows	Non-IEEE Member	 	
Academic Rate
IEEE Membership # ………………	565 €	615 €	______ €	
Industry rate
IEEE Membership #........................	765 €	815 €	______ €	
Additional late fee *
- after July 19 /2010, 100 €
- after August 19/2010, 150 €
* late payment acceptable for attendance only
* authors must register before July 19	                                                                               
   ______ €	
Additional Proceedings: 100 €/CD	                                                                                 
   ______ €	
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

Hotels
Conference Hotel:
Hotel Novotel Firenze Nord Aeroporto
http://www.novotel.com/gb/hotel-1798-novotel-firenze-nord-aeroporto/index.shtml

Via Tevere 23 
Osmannoro 
50019 FIRENZE SESTO FIORENTINO 
ITALY 
Tel (+39) 055/53821 
Fax (+39) 055/308336 

Other hotels: see “Touristic Information” on the conference site

D. Social Event - Tour [October 30, 2010]

Firenze/Pisa/Tuscany Region                                           150 € 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 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 19th, 2010 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.