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					                                                 Registration Form
                       Conference on Computer Science & Computational Mathematics
                                             (CCSCM 2012)

                                    Date: 9 - 10 February 2012, Venue: Malaysia

                      Please fill in the form, sign by hand, and send it via email to the following address:
                                                  E-mail: mailto:info@ccscm.net



Title (Student/Prof/Dr): _____ First Name: ___________________Last Name: _______________________

Paper ID: ____ Paper Title: _________________________________________________ (for authors only)

Institution:
_______________________________________________________________________________

Street Address:
____________________________________________________________________________

City: __________________ State: _____________ Country: _______________________ Zip: ___________

Phone: ___________________ Fax: __________________ Email: __________________________________

Dietary Requirements: ______________________ Attending conference:                                Yes      /   No




Conference Registration Fees
The full registration fee includes: Keynote & invited speakers session(s) (if any), concurrent sessions of Technical
Program, Conference Proceedings, lunch, morning and afternoon refreshment breaks and CCSCM gift.
Regular Papers

     Tick appropriate
                                                      Category                                      Registration Fee (EUR)
         category
                          Early-bird registration - Author (Student)                           280
                          Early-bird registration – Author                                     310
                          Additional Authors                                                   200/pax
                          Additional Papers                                                    200/paper
                          Extra Pages (up to 4 extra pages)                                    50/page
                          Late registration - Author (Student)                                 350
                          Late registration – Author                                           390
                          Non-Author Participant                                               250
                          Non-Author Participant + Proceedings                                 350


Posters

     Tick appropriate
                                                      Category                                      Registration Fee (EUR)
         category
                          Early-bird registration - Author (Student)                           250
                          Early-bird registration – Author                                     280
                          Additional Authors                                                   170/pax
                          Additional Posters                                                   170/paper
                          Late registration - Author (Student)                                 320
                          Late registration – Author                                           350
                          Non-Author Participant                                               200
                          Non-Author Participant + Proceedings                                 250

Note:
- In order to avail of the student rates, a formal letter from their University is required.

- If the registered participant is unable to attend, the registration may be transferred to another presenter. S/he must inform the
Conference a month before the conference. No refunds will be issued.


Payment methods

Credit/Debit Cards

Payment can be made online via PayPal. Please follow the link provided on the conference website.
Please email the Conference your PayPal payment slip along with the registration form.

*All PayPal transactions will include a 5% PayPal administrative fee.




Author’s Signature and date:

				
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