IEEE Information Theory Workshop

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					                                      The 10th International Workshop
                                    on Information Security Applications
                                                 (WISA 2009)
                                          Busan, Korea, August 25 – 27, 2009
                                                        Registration Form



 Please check:           Speaker                                (  General Participant                     Full-time Student)
                        (Title of paper :                                                                                         )
                          non-Speaker                            (  General Participant                     Full-time Student)
Title:  Dr.       Mr.        Ms.
First Name:                                                  Last Name:
Affiliation:
Mailing Address:


Country:
                                                                    Post/Zip Code:

E-mail address:
Fax:                                                        Phone:



                                             Before Aug. 7                 After Aug. 7
General Participant                          $500 (\600,000)               $600 (\700,000)                    $(\)

Full-time Student                            $270(\330,000)                $350 (\420,000)                    $(\)

Banquet : extra banquet ticket $80 (\96,000) per person X                           (# of persons) =            $(\)

LNCS proceedings :                         $80 (\96,000) per copy            X       (# of copies)       =     $(\)
※All registrations do not include LNCS proceedings.
Total Amount                                                                                             $(\)


Registration includes proceedings CD, refreshments during the conference, and banquet.
Student registration includes proceedings CD and refreshments ONLY.

(International Participants)
Please charge my  VISA                       MASTER
Cardholders name                                Card number                             (CVC        )   Expiration date
    Please find enclosed a copy of the bank/wire transfer payment to WISA2009, Kookmin Bank, Yeoksam Station
     Branch, for account # 754-01-0008-146 ( depositor : KIISC).
     Date                                    Signature


    PLEASE MAIL OR FAX TO:                                                       Tel: +82-2-564-9333
    Korea Institute of Information Security & Cryptology                         Fax: +82-2-564-9226
    Seongji Heights 3-Cha bldg., Room 909                                        E-mail : kiisc2@kornet.net
    642-6 Yeoksam 1-dong,Gangnam gu, Seoul 135-717, Korea                        http://www.wisa.or.kr

Registration will be completed only upon receipt of payment.

                                                              \
No refunds after Aug. 7, 2009. Substitutes are permitted. $60 ( 72,000) cancellation fee for cancellations received before Aug. 7, 2009