ICW'05, ICHSN’05, ICMCS’05, SENET’05 Registration Form 

Along with your registration form, please send to petre@iaria.org and oana@vicov.com the pdf file of your final paper version.

Registration form can be sent by email (preferred), fax, and mail as specified in 
http://www.iaria.org/conferences/ICW/ICW2005/RegistrationForm/RegistrationForm.html 

Title (Prof, Dr, student): _____ First Name: _________ Last Name: _______________ 
Paper number generated by EDAS (for authors only, one paper per from): ____________
Institution: ________________________________________________________________
Street Address: ____________________________________________________________
City: _________  State: ____________  Zip: ___________  Country: __________________
Phone: ______________ Fax: _______________ Email : ___________________________
The full registration fees include: attendance to the conference, the reception, the coffee breaks, the gala dinner and the proceedings.
 
 	Non Member	IEE-IEEE-SEE, Member	 	
Academic Rate Membership #	650 USD	600 USD	______ USD	
Industry rate Membership #	750 USD	700 USD	______ USD	
Additional Conference Proceeding: 100 USD							    ______ USD	
Additional Gala Dinner: 80 USD							    ______ USD	
Additional extra pages (100 USD per page)   							    ______ USD	
Tutorial 1 (150 USD)							    ______ USD	
Tutorial 2 (150 USD)							    ______ USD	
Tutorial 3 (150 USD)							    ______ USD	
Tutorial 4 (150 USD)							    ______ USD	

Total USD:      _________
Payment of Fees: 
__ By Foreign Check in USD to “VICOV Event Expert LLC." (address is on conference Registration Form page)
 
__ By Credit Card   (__ MasterCard  __ Visa)   

            Card number:    _______________________________________

             Expiration date:  _____/_____                Holder's Name : ____________________

                                      Date / Signature: …………… / ………………….
Important: 
-	Please note that NO refund will be issued after May 25, 2005  
-	Conference will be held at Holiday Inn Select, Montreal Downtown