All registration fees include the 19.6% Value Added Tax (VAT)
All fees will be collected in US Dollars.
An original invoice in compliance with VAT regulations for submission of reclaim will be mailed upon request.
The exchange rate used is: 1 Euro (EUR) = 1.38610 US Dollar (USD) effective 20 Oct. 2010.
It will be updated monthly if it changes more than 2.5%
Registrant Information (Please print clearly)
* INDICATES A REQUIRED FIELD
*Last/Family/Surname
*First/Given Name
*Organization
* Address (Line 1)
*City
Address (Line 2)
US State/Canadian Province
Primary Contact #
Fax #
Postal/Zip Code
*Country/Region
*Email (A valid email address is required to receive confirmation)
Emergency Contact
Emergency Contact #
IEEE Member Number: ___________________
If you have a disability and may require special accommodations in order to fully participate, please check the box below. You
will be contacted by someone from our staff to discuss your specific needs.
Please check the box if you have any special
needs.
Please indicate your special need _______________________________________________________________________
Please indicate your dietary restrictions _________________________________________________________________
(ie. Lactose Intolerance, Allergies, religious/cultural traditions)
Note: IEEE may contact you regarding similar IEEE conferences, services, and/or technical products. If you prefer not to be contacted
please check “No”. □ No
Is this your first time attending this conference? (Check one)
How did you hear about this event?
 Yes
 No
______________________________________________________________________
What is your main reason for registering? ________________________________________________________
IMPORTANT INFORMATION FOR AUTHORS
If you are an Author, you must register at the R01 or R02 category (see page 2) even if you are a student. For authors
presenting multiple papers, one registration of R01 or R02 must be attached to each paper. A single exception is when up
to two (2) papers are authored by the same single author, in which case one registration covers both papers. You may
pay an extra fee equal to your registration fee for each extra paper. The maximum number of pages per paper is five (5).
You may purchase extra pages, a max of four (4) per paper, at a cost of $90 each. The deadline for Author registration is
07 December 2011.
 EDAS 10 digit # _____________
_____________
_____________
_____________
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*REGISTRATION CATEGORIES







R01
R02
R03
R04
R05
R06
R07
–
–
–
–
–
–
–
On/By 7 December
IEEE Member
Non-Member
Student
One Day – IEEE Member*
One Day – Non-Member*
Tutorial(s)/Workshop(s) ONLY
Conference attendee (non authors)**
*ONE DAY Attendees please check which day:
After 7 December
US$900
US$950
US$500
US$450
US$500
See Prices Below
US$900
 Monday
 Tuesday
US$1000
US$1050
US$600
US$500
US$550
US$__________
US$__________
US$__________
US$__________
US$__________
US$900
US$__________
 Wednesday
 Thursday
** No refund is possible for this registration category in case of cancellation
R01 & R02 & R07 REGISTRATION includes: Admission to Keynote Sessions, Technical Sessions, Tutorials, One Copy of the
Conference Proceedings, Coffee Breaks, Welcome Reception, and Banquet
R03 REGISTRATION includes: Admission to Keynote Sessions, Technical Sessions, Tutorials, One Copy of the Conference
Proceedings, Coffee Breaks and Welcome Reception
R04 & R05 REGISTRATION includes: Admission to Keynote Sessions, Technical Sessions, One Copy of the Conference Proceedings
and Coffee Breaks
ADDITIONAL ITEMS
 Qty_______ Additional
 Qty_______ Additional
 Qty_______ Additional
 Qty_______ Additional
Banquet Ticket (9 Feb.) - US$90 each
Copy of Proceedings - US$40 each
Page(s) Fee - US$90 per page (over 5 pages, max 4 pages per paper)
Paper Charge - fee equal to your reg. category fee
US$__________
US$__________
US$__________
US$__________
TUTORIALS (Fee applies for R04–R06 registration categories. Tutorials are included for other categories: R01–R03)
 T01 -– US$200
US$__________
 T02 -– US$200
US$__________
WORKSHOPS
 WSN 2011 (Full Day) – US$640
 SCLP 2011 (Half Day) –US$490
 INNOV 2011(Half Day)–US$490
Registration Total
$__________________
Additional Total
+
$__________________
US$__________
US$__________
US$__________
Tutorials Total
$__________________
Workshops Total
+
$__________________
Total Remittance
=
$__________________
CANCELLATION POLICY
All refund/cancellation requests must be provided in writing and received by 22 December 2011. There will be an
administrative fee of $90 deducted from each refund. Please submit all requests to ntms11reg@ieee.org
VISA ASSISTANCE
If you are requiring visa assistance letters you must complete the Visa Assistance Request form.
http://www.ntms-conf.org/visa/.
Method of Payment:
Check- Please make payable to: 2011 NTMS Conference
Wire Transfer US$20 fee– Please contact ntms11reg@ieee.org for instructions
Credit Card:
Visa
MasterCard
American Express
Discover
Card Number _____________________________________________________Exp.Date_____________CVV ________
Name on Card_______________________________________ Authorized Signature ____________________________
Mail/Fax Completed Registration Form & Fees To: (Please do not submit this form without payment. Wire transfers – please attach a copy
of your wire transfer receipt) IEEE/MCM: Deidre Zeigler, CMP Registrar, 445 Hoes Lane, Piscataway, New Jersey 08854-4141 USA Tel: +1 732
465 7810 Toll Free (in US or Canada): + 1 800 810 4333 Fax: +1 732 465 6447 E-mail: ntms11reg@ieee.org
Non-discrimination: "IEEE is committed to the principle that all persons shall have equal access to programs, facilities, services, and
employment without regard to personal characteristics not related to ability, performance, or qualifications as determined by IEEE policy
and/or applicable laws. For more information on the IEEE policy visit http://www.ieee.org/nondiscrimination
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