Icccn07 (Author) Registration Form

ICCCN 2016 CONFERENCE “AUTHOR” REGISTRATION FORM (AUTHOR REGISTRATION DEADLINE: MAY 9, 2016 ) August 1 - 4, 2016, Waikoloa Beach Marriott Resort Hotel, Waikoloa, Hawaii USA

PLEASE read ENTIRE REG. FORM before you complete the form!! Complete the form and email/fax it with your payment info (Please type or word process. "NO" Hand-Written Please!!). Your Paper #1 (EasyChair Paper ID #): ______Title:______Authors:______Your Paper #2 (EasyChair Paper ID #): ______Title:______Authors:______Your First Name:______Last Name:______Title (Dr/Prof/Mr/Ms/):______Student (check one): Yes:______No:______Company/Univ.:______Dept.:______Address:______City:______State:______Zip/Postal Code:______Country:______Phone:______Fax:______Email:______

AUTHOR RATE - A full reg. fee payment covers up to two conf. papers (the registrant must be the common author of the two accepted papers; otherwise one full reg. fee covers one accepted paper). The reg. form and fee payment must be received by ICCCN 2016 conference by May 9, 2016 (or your paper may be excluded from the ICCCN2016 conference proceedings). Note that there is an extra page charge beyond 9 pages at US$100 per extra page up to two extra pages for EACH accepted paper.

Full Conference Reg. Fee (covers up to two conf. papers): ______IEEE Member (US$750) ______Non IEEE Member (US$800) If you are interested in attending both ICCCN 2016 Conference and Workshops (without workshop papers), the reg. rate is: ______IEEE Member (US$800) ______Non IEEE Member (US$850) ------Reg. Fee from above: $ ______(Provide your IEEE Membership # if any. See below) Extra page charge (US$100.00 PER extra page Up to TWO extra pages, beyond 9 pages): $ ______Total number of pages in your Paper #1: ______Paper #2: ______Extra Conf. Reception Tickets ($50 each): $ ______Extra Conf. Banquet Ticket ($100 each): $ ______Extra copy of proceedings ($60/each): $ ______(combined conf/workshop proceedings) Add US$150.00 late fee after MAY 9, 2016 $ ______Total Fees Enclosed: US$ ______

Your Signature:______Date:______

Your membership -- IEEE:_____ or ComSoc:_____ (please check one)

Membership #: ______(Required for member rate and must be verifiable with IEEE or ComSoc)

The paid/registered author of accepted paper must come and give a presentation at ICCCN2016, or your paper will be excluded from the IEEE Xplore. We do not allow presentations by non-authors for accepted papers.

* Do you need an invitation letter for USA entry visa application? ___Yes ___No (invitation letters will be issued only after your reg. fee is paid) * Please let us know if you are planning to attend any of the following events (please put check marks): August 1, 2016: Reception: Will you attend? YES___ NO___ August 2, 2016: Banquet: Will you attend? YES___ NO___ Full Registration includes: A copy of the ICCCN 2016 proceedings, the Reception, and the Banquet. *After May 9, 2016, please add US$150 late fee to the total (if a correct amount including any extra page charge is not paid by May 9, 2016, the late fee still will be charged. We cannot guarantee the inclusion of your paper in the ICCCN2016 conference proceedings and technical programs if a full reg. fee is not received by May 9, 2016). @@@@@@@@@@ Preferred Registration and Fee Payment Method @@@@@@@@@@@@@@

1. SCAN your reg. form (after you fill in the credit card info and sign the reg. form) and save it in a pdf or doc file 2. EMAIL the scanned reg. form in PDF or DOC file to: [email protected] @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ Payment Method (your reg. form/fee payment MUST be received by May 9, 2016, not postmarked by): Credit card type (check one): VISA_____ or MasterCard______(NO Amex)

Card Number: _ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _ Exp Date:_ _/_ _ _ _ (MM/YYYY); CVV#: _ _ _ (CVV # is Card Verification Value on the back of your card, next to card owner’s signature). Card billing address:______, ______, ___, ____, ______, ______street #, street name, city, state, zip/postal code, country name are required!!

Cardholder’s Name (on the card):______

Cardholder’s Signature: ______Date: ______

* SCAN in and email this form to: [email protected] (PREFERRED Method) or FAX this form to (913)660-0904 (secure and dedicated fax line for ICCCN16) by NO LATER THAN MAY 9, 2016. ======ICCCN 2016 Hotel Reservation: The ICCCN 2016 has contractual obligations to fill guaranteed guest room blocks at Waikoloa Beach Marriott Hotel, Waikoloa, Hawaii. Significant financial penalties will be assessed the icccn16 conference should the icccn16 conference fall short of the expected number of rooms guaranteed. By staying at the Waikoloa Beach Marriott Hotel, you'll enjoy logistical conveniences and additional networking opportunities in valued support of ICCCN's financial obligations. ICCCN 2016 POLICY: 1. ICCCN 2016 conference accepted paper presenters’ must register at the FULL rate. Each FULL registration fee covers up to two conference papers (but the registrant must be a common author of the two papers). 2. Refund Policy: NO refund of reg. fees paid by authors of any accepted papers is allowed at any case. 3. ICCCN2016 Conference and Workshops assume NO responsibility for actions of the authors/attendees or injuries sustained by them during the conference/workshops period and assume NO responsibility in connection with the attendees' participation in the conference/workshops. 4. Author Registration Transfer: Transfer of the paid registration by any author is allowed only to one of co-authors of the same accepted papers who must be a common author of the accepted papers (if more than one papers are involved). This transfer request must be received by ICCCN2016 one month prior to the conference. One registration fee only covers one person. We assume that you have read and agreed to all the terms, conditions, and policies stated above and in this form by registering and submitting this registration form with a credit card or other form of payment by you to ICCCN 2016 conference. [ ] Yes, please send me IEEE Communication Society membership and event promotional materials. ===== Cut here before you email, fax, or mail your reg. form ( please do not send/fax this page !!) ======

If you are going to register by bank wire transfer or by regular post office mail with a payment check or money order or credit card, please contact Registration Chair as soon as possible at [email protected] for instructions.

* We MUST RECEIVE your reg. form and payment by MAY 9, 2016 to secure your paper in the ICCCN 2016 Proceedings and technical program. One registration fee only covers one person.

* All payments MUST be in U.S. dollars.

* A receipt will be emailed to you after your reg. fee is charged successfully to the credit card you provided.

* All registration materials including proceedings and receipts must be picked up only at the registration desk ON SITE at the conference (we will not mail any of these before or after the conference).

* If you have any questions on registration, contact Reg. Chair at [email protected]

* Please apply your USA entry visa as soon as possible if needed.

* Please make your hotel reservation (refer to the information posted at the ICCCN2016 website).

* There is NO student rate for the author who is responsible for registration for his/her accepted paper.

* Please visit our Website regularly for up-to-date program information and related activities at:

WWW.ICCCN.ORG/ICCCN16/ ======