Intelligent Finance Visa Credit Card
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Intelligent Finance Visa Credit Card document sample
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The 4th International Conference on
Intelligent Environments IE08
21 – 22 July 2008; University of Washington, Seattle, USA
Author Registration Form
One form per person only (forms may be photocopied)
REGISTRATION (Please complete in CAPITALS)
Conditions of Booking Family Name _________________________________ Title (Mr, Mrs, Miss etc) _________
Application Forms should be completed First Name___________________________________ Job Title _____________________
and returned to the address below and
must be accompanied with the correct
payment. Attendance at the event will only
Institution of Engineering and Technology Membership No ____________________________
be confirmed on receipt of the full
payment. Name of Organisation (for name badge) __________________________________________
All Author registration forms should be received Address for Correspondence ___________________________________________________
no later than Friday, 16 May 2008 to ensure
that your paper is not withdrawn from the ___________________________________________________________________________
conference.
Cancellation In the event of cancellation after Town/City __________________________________________________________________
Friday, 16 May, no refund can be made. The
Institution of Engineering and Technology Postcode ____________________________________ Country ______________________
reserves the right to cancel any event. In this
case, the full fee will be refunded unless a
mutually convenient transfer can be arranged. Contact Telephone ____________________________ Fax _________________________
Details of event changes or cancellations are
available by phoning Email ______________________________________________________________________
+44 (0)1438 765 657
Name Substitutions are accepted at any time Do you have any dietary or other requirements? ____________________________________
by fax or email.
Fax: +44 (0)1438 765659 How did you hear about this event?
Email: eventscs1@theiet.org
Flyer in Post Email Advert (Institution Publication) Advert (Other) The IET Website Other
Delegates with Special Needs The Institution
of Engineering and Technology aims to offer FEES AND CHARGES (Please complete the appropriate box)
fully accessible events to all its delegates.
Please help us to accommodate any individual The author rate registration fee includes having a maximum of two papers presented at the
needs that you may have by attaching a note to conference, attendance at the sessions, a copy of the conference proceedings, refreshments,
the registration form. We will contact you to lunch and attendance at the conference dinner.
discuss this as necessary.
Data Protection - The information that you provide
Author’s presenting more than two papers must pay the additional paper fee.
to the IET and its associated organisations will be
used to ensure we provide you with products and AUTHOR REGISTRATION (On or before 16 May 2008) $ c
services that best meet your needs. This may
include the promotion of specific IET and Author Rate $415.00
associated organisations products and services by
post and/or electronic means. By providing us with
Additional Paper Fee $300.00
your email address and/or mobile telephone
number you agree that we may contact you by
Total Remittance
electronic means. You can change this preference
at any time by visiting www.theiet.org/my.
The Institution of Engineering and Technology Paper Serial Number
is not, as a body, responsible for the views or
opinions expressed by individual authors or Presenting Author
speakers. Paper Title
Complete and return this form to: PAYMENT DETAILS
The Institution of Engineering and
Technology Payment must accompany this registration form. Registration will only be confirmed on receipt of
Finance Department full payment.
P O Box 96
Stevenage
PLEASE NOTE: Payment via Purchase Order is not accepted
Herts SG1 2SD, UK
Fax: +44 (0)1438 765 659
Please indicate the method of payment: Cheque Credit Card BACS
For all enquiries telephone Cheques should be made payable to “IET” and crossed.
+44 (0)1438 765 648 or email
eventsa2@theiet.org Credit Card Visa MasterCard AMEX Switch Issue No _____ Valid from ____/____
Card Number
The Institution of Engineering and Technology Expiry Date M M Y Y
CSC (Card Security Code)
is registered as a Charity in England & Wales Last 3/4 digits on signature strip
(no 211014) and Scotland (no SC038698) Name of Cardholder
Full registered address of Cardholder (if different from above) ___________________________
_______________________________________________ Postcode ____________________
For office use only :
Ref: 12404 Bank Transfers (BACS) can be made to Barclays Bank Plc, UK Bank, 1 Churchill Place, London, E14
F312359 5HP. USD Account no: 42221333 Sort code: 20-65-82 IBAN GB43BARC 2065 8242 2213 33. A copy of the
Robotics & Mechatronics Network Draft must accompany this form. Delegates must be aware that the Institution is not responsible for any gains or
losses as a result of fluctuations in the Exchange rate.
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