Nanotechnology and Printed Electronics International Symposium
(NanoPrint 2011)
Nanyang Technological University, Singapore
4th – 5th July 2011
REGISTRATION FORM
Complete this form and fax / email to:
Fax: (65) 67947553
Email: nanoprint@ntu.edu.sg
Personal Particulars of Delegates
(Please type clearly and use separate registration form for each delegate)
Please tick
Prof.
Dr.
Mr.
Mrs.
Ms.
Family Name:
Given Name:
Organization:
Mailing Address:
City:
Postal Code:
Country:
Tel:
Fax:
Email:
Conference Registration Fee (in Singapore dollars)
Cat ego r ie s
1) All Delegates
2) Bona fide full time student only
**
Reg i str at ion F ee * *
O n o r bef or e 8 J un e 20 1 1
Af te r 8 J un e 2 01 1
SGD 750.00
SGD 850.00
SGD 550.00
SGD 650.00
The registration fee for all delegates covers admission to the event, daily lunch and coffee breaks, a welcome
reception, a banquet and book of abstracts.
The registration fee for student does not cover the welcome reception and banquet.
The registration fee does NOT cover accommodation.
Payment (by cheque / bank draft)
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

Full payment of registration fee is required. Please make payment by cheque / bank draft
payable to “SCBE-Nanoprint” and mail to the following address: School of Chemical and
Biomedical Engineering, Nanyang Technological University, N1.2, Level B3-13, 62 Nanyang
Drive, Singapore 637459
Cancellations will not be entitled to any refund. Replacement of delegates is acceptable. Any
replacement must be faxed to the secretariat by 25 June 2011.
Please take note that bank charges are to be borne by the participants.
My registration fee of
Signature of Delegate:
is being paid by cheque / bank draft no.
Date: