DS-RT Author DS-RT Author Registration Form DS-RT Paper ID#: dsrt1 dsrt2 dsrt3 dsrt4 dsrt5 dsrt6 dsrt7 dsrt8 dsrt9 dsrt10 dsrt11 dsrt12 dsrt13 dsrt14 dsrt15 dsrt16 dsrt17 dsrt18 dsrt19 dsrt20 dsrt21 dsrt22 dsrt23 dsrt24 dsrt25 dsrt26 dsrt27 dsrt28 dsrt29 dsrt30 dsrt31 dsrt32 You cannot find your paper ID. Click here. DS-RT Paper Title: Name of the author registering/attending the event *(ONE Author name per registration): Affiliation: Address: Country: Telephone: Fax: E-mail: DS-RT 12* Registration Charges - Please check appropriate fees IEEE/ACM Member (550 US Dollars) Valid IEEE/ACM Membership Number: Non-member (700 US Dollars) * This registration covers only ONE paper. If the same author has more than one accepted paper, only ONE extra paper can be included in this registration (for a reduced fee of 400 US Dollars). This will guarantee that your papers will appear in the IEEE proceedings. Additional Paper = ONLY DS-RT Paper's ID#: dsrt1 dsrt2 dsrt3 dsrt4 dsrt5 dsrt6 dsrt7 dsrt8 dsrt9 dsrt10 dsrt11 dsrt12 dsrt13 dsrt14 dsrt15 dsrt16 dsrt17 dsrt18 dsrt19 dsrt20 dsrt21 dsrt22 dsrt23 dsrt24 dsrt25 dsrt26 dsrt27 dsrt28 dsrt29 dsrt30 dsrt31 dsrt32 You cannot find your paper ID. Click here. Additional Pages (100 US Dollars per page) = Additional DS-RT'12 Proceedings (50 US Dollars per copy) = PS: Note that no refunds will be provided for any additional proceedings you have decided to purchase. Tutorials (120 US Dollars per Tutorial) = Extra DS-RT Banquet (Dinner) (55 US Dollars per person) = Total Amount (registration + proceedings + Tutorials) US Dollars The DS-RT'2012 Conference fees will cover attendance to DS-RT Technical sessions, reception, coffee breaks, All DS-RT Workshop/Symposias, ONE DS-RT Main Conf. proceedings*, and a ONE Banquet (Dinner). Method of Payment Credit Card. *(NOTE THAT ALL CHARGES WILL BE IN US DOLLARS) - When paying using your Credit Card, you must use Master Card or VISA ONLY. If you have any questions, please Contact the DS-RT' 12 Finance Chair (A. Boukerche). Credit Card type: VISA MasterCard Expiration Date: Credit Card Number: CVV2 (Security code): Card Holder Name: (NOTE: as it appears in the Credit Card.) Card Billing Address: Total Amount (US Dollars): Email of the Contact Person: Email: Non-Author Non-Author Registration Form Name of the attendee: Affiliation: Address: Country: Telephone: Fax: E-mail: DS-RT 12* Registration Charges - Deadline September 25th, 2012 Before September 25th After September 25th IEEE/ACM Member Valid IEEE/ACM Membership Number: 550 US Dollars 700 US Dollars Non-member Including IEEE/ACM Membership 700 US Dollars 875 US Dollars Additional DS-RT'12 Proceedings (50 US Dollars per copy) = PS: Note that no refunds will be provided for any additional proceedings you have decided to purchase. Tutorials (120 US Dollars per Tutorial) = Extra DS-RT Banquet (Dinner) (55 US Dollars per person) = Total Amount (registration + proceedings + Tutorials) US Dollars The DS-RT'2012 Conference fees will cover attendance to DS-RT Technical sessions, reception, coffee breaks, All DS-RT Workshop/Symposias, ONE DS-RT Main Conf. proceedings*, and a ONE Banquet (Dinner). Method of Payment Credit Card. *(NOTE THAT ALL CHARGES WILL BE IN US DOLLARS) - When paying using your Credit Card, you must use Master Card or VISA ONLY. If you have any questions, please Contact the DS-RT' 12 Finance Chair (A. Boukerche). Credit Card type: VISA MasterCard Expiration Date: Credit Card Number: CVV2 (Security code): Card Holder: (NOTE: as it appears in the Credit Card.) Card Billing Address: Total Amount (US Dollars): Email of the Contact Person: Email:
