Registration form of the ICCSCI 2015 The 1st International Conference on Computer Science and Computational Intelligence (ICCSCI2015) August 24-26, 2015, Jakarta, Indonesia http://socs.binus.ac.id/iccsci/

The ICCSCI 2015 will be held during August 24-26, 2015 in Jakarta. Please note that it is essential for all participants to send a completed Registration Form, Final Papers and List of Revision, and Proof of Payment to [email protected] before May, 30 2015. 1. General Information Prefix: Male □ Female □ First Name: Family Name:

Whether attend the Conference: Yes □ No □

(Photograph) Position: Organization or University: Research Area:

Organization or University Address:

City: State: Country: Postcode: Telephone: Fax: Mobile: Email: Special Needs or Dietary Requirements: □ Vegetarian □ Muslim □ Other (please specify): Attend the tour : Yes □ No □ Paper ID Code: Paper Title:

Paper Author (s):

Author(s) Email:

1 Paper Pages: Additional Page:

2 2. Attendee Information  We will prepare the certificate for the attendee only, either as presenter or participant)  Each payment is for one person only

Name :

Paper ID:

Paper Title:

Organization: 3. Payment Registration Fee is paid by using US Dollar or IDR Rupiah.

Registration Fee Registration Fee Categories (International) (Indonesia)

General presenter (Early bird) 400 USD 4.500.000 IDR

Additional submitted paper (Early bird) 300 USD 3.500.000 IDR

General presenter 550 USD 6.000.000 IDR

Additional submitted paper 350 USD 4.000.000 IDR

Non-presenter (Student) 200 USD 300.000 IDR

Non-presenter (Non-Student) 200 USD 500.000 IDR

Note :  One regular registration can cover a paper within ten pages, including all figures, tables, and references.

3 Payment Method :

 For USD :

For USD amount Payment Method is Telegraphic Transfer ( TT ) “Full Amount”

Account number : 5270297970 Account name : Univ. Bina Nusantara Bank name : Bank Central Asia (BCA) Branch name : Universitas Bina Nusantara City : Jakarta Country : Indonesia Swift Code : CENAIDJA Currency : USD

 For IDR :

Account number : 5270296698 Account name : Univ. Bina Nusantara Bank name : Bank Central Asia (BCA) Branch name : Universitas Bina Nusantara City : Jakarta Country : Indonesia Currency : IDR

4 COPYRIGHT FORM

Elsevier has now automated the exclusive license transfer process. The copyright form will be directly sent to the Authors during production. Please notice to put your active email and your email inbox regarding the copyright form which is sent by Elsevier during the production.

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