2012 Joint International Conferences

July 24-25, 2012, Liverpool, England, UK

England Office: A27, Sackville Street Building, The University of Manchester, Sackville Street, Manchester, M60 1QD, UK

www.WJMS.org.uk/ICMS2012, www.JIC.org.uk/ICIC2012, www.TexEng.co.uk

Please return this registration form before 10 April 2012 along with your payment details to .

Application/Registration form

I apply/register with details below to attend the ICMS2012: The Firth International Conference on Modelling and Simulation

□ Female □ Male

Title (e.g. Dr./Prof./Mr./Mrs./Ms.):

First Name:

Last Name (Surname):

Name for Badge:

Organization/Institute:

Department:

Address:

City: Province (State):

Postal (Zip) Code:

Country:

Telephone: ( )

Fax: ( )

Email:

Name of accompanying person:

Special dietary requirement:

Please check this box if you DO NOT consent to your organization, address, fax and e-mail appearing on the participant List:

□Do not put my details on the participant list

PRESENTATION (for speaker only)

Reference Number
and The Presenter / Abstract/Paper Title / I would like to make a Oral / Poster presentation ( Check by √ )
□Oral
□Poster
□Non-presentation
Please write a few sentences about the presenter below for the conference chairs to introduce you to audience before oral presentation.

Reference Number: the ref no we assigned when you submit your abstract/paper. Presenter: (who will make oral presentation, if appropriate).

CONFERENCE REGISTRATION AND FEE

Description / Until April 10, 2012 / From April 10, 2012 / Amount
Delegate Registration Fee for Member of IACSS, SIAM, CSIAM, CSSS / British Pound (GBP) £270 / British Pound (GBP) £350 / (GBP)
Delegate Registration Fee for Others / British Pound (GBP) £300 / British Pound (GBP) £350 / (GBP)
Accompanying registration fee
(optional) / How many?
Name? / British Pound (GBP) £150 per head / (GBP)
Total amount payable / (GBP)

Note:

Accompanying registration fee is only for accompanying person who come with delegate. Accompanying person does not need to fill in the registration form separately.

Please find more explanation below.

Delegate Registration Fee / Accompanying registration fee
Conference proceedings / Including / Not including
Briefcase (file folder) / Including / Not including
Opening ceremony and
Conference Session / Including / Not including
Badge / Including / Accompanying badge
Lunch of 24 and 25 July / Including / Including
Dinner of 24 July / Including / Including

Payment:

□ (Please quote ref “ICMS” and your Name) I have paid GBP (£) ……… direct to England, UK at:

Refund Policy:

A 50% administration fee will be withheld for cancellations received in writing prior to or on April 15, 2012. NO REFUNDS will be issued after this date

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