CONFERENCE AND HOTEL REGISTRATION FORM
Please fill out the Registration Form, submit it to Gilberto Chaves - DC&Travel () with copy to
______
Requests for refunds received before February 20th, 2016 will be subject to a USD 120.00 processing fee. No refunds will be made for cancellations received after February 20th, 2016 and all registration fees will be forfeited.
LATS2016 SYMPOSIUMREGSITRATION
1: All prices are in Brazilian Reals (BRL). Average exchange rate: 1.00 USD is approximately 4.01BRL
2: Registration includes: Proceedings (Pen-Drive), 5 Coffee-Breaks, 3 Lunch, Souvenirs, Social Event & Gala Dinner and Welcome Reception.
3: Student Registration does not include Social Event & Gala Dinner.
Deadline for Advance Symposium Registration: February10th, 2016
LATS2016 TTEP REGSITRATION
1: All prices are in Brazilian Reals (BRL). Average exchange rate: 1.00 USD is approximately 4.01 BRL
2: Registration includes: 2 Coffee-Breaks and 1 Lunch
Deadline for Advance TTEP Registration: February10th, 2016
17th IEEE LATIN AMERICAN TEST SYMPOSIUM – LATS2016
SYMPOSIUM AND TTEP REGISTRATION FORM:
First Name: ......
Last Name: ......
IEEE Membership Number: ......
Affiliation: ......
Street Address: ......
City: ......
State: ......
Zip Code: ...... Country: ......
Tel: ...... Fax: ......
Email: ......
(a) Symposium Registration Fee: R$ ......
(b) TTEP Registration Fee: R$ ......
(c) Additional charges for companion:
...... lunch(es) - RS 80.00 each
Welcome Reception - R$ 150.00: [ ]
Social Event (Iguaçu Falls National Park) - R$ 300.00: [ ]
Gala Dinner - R$ 250.00: [ ]
(a+b+c) Total amount to be charged: R$ ......
In order to please all tastes, we propose two different manners to visit the National Park during the Social Event. Please indicate ifyou prefer to explore the National Park
by boat [ ]
or by trail (on feet) [ ]
Choose Credit Card Type: ......
Card No...... Security Code: ...... Exp. Date ......
Name (as it appears on card) ......
Signature ......
Please fill out the Registration Form, submit it to Gilberto Chaves - DC&Travel () with copy to
______
Requests for refunds received before February 20th, 2016 will be subject to a USD 120.00 processing fee. No refunds will be made for cancellations received after February 20th, 2016 and all registration fees will be forfeited.
LATS2016 HOTEL REGSITRATION
Wish Golf Resort Foz de Iguaçu
Av. das Cataratas , 6.845 - Tamanduá, Foz do Iguaçu, Paraná, 85.853-000, Brazil
1: All prices are in Brazilian Reals (BRL). Average exchange rate: 1.00 USD is approximately 4.01 BRL
2: Prices include all taxes.
3: Breakfast is included.
Deadline for Advance Registration: February10th, 2016
17th IEEE LATIN AMERICAN TEST SYMPOSIUM – LATS2016
HOTEL REGISTRATION FORM:
First Name: ......
Last Name: ......
IEEE Membership Number: ......
Affiliation: ......
Street Address: ......
City: ......
State: ......
Zip Code: ...... Country: ......
Tel: ...... Fax: ......
Email: ......
Check-In Date: ...... / ...... / 2016 (dd/mm/yyyy)
Check-Out Date: ...... / ...... / 2016 (dd/mm/yyyy)
Choose Credit Card Type: ......
Card No...... Security Code: ...... Exp. Date ......
Name (as it appears on card) ......
Signature ......
Please fill out the Registration Form, submit it to Gilberto Chaves - DC&Travel () with copy to
______
Requests for refunds received before February 20th, 2016 will be subject to a USD 120.00 processing fee. No refunds will be made for cancellations received after February 20th, 2016 and all registration fees will be forfeited.