/ IFIP Neworking’2015 Conference
Toulouse, France – May 20-22, 2015 /

IFIP Networking’2015 Registration form

Please fill in the form, sign it, and send it via one of the following:
Michele NAHUM - Joubert Voyages - Fax: +331 48 74 40 60
Email:

Title (Mrs., Ms., M., Dr., Prof): …… Last/Family name:

First name: ………………………………………………….…. EDAS paper Id: …………………….……

Organization:

Address: ..

City: …………………………………………… Country:

Phone: …………………… Fax:………………………… E-mail:

IEEE membership number:

REGISTRATION FEES

In order that the papers appear in the conference proceedings, paper authors must register by March 25, 2015. Each paper must have a full registration associated with it.

Authors / Non-authors
BEFORE
March 26, 2015 / BEFORE
April 20, 2015 / AFTER
April 20, 2015
Conference registration
● IFIP or IEEE members (1) / 530 Euro / 530 Euro / 630 Euro
● Non IFIP/IEEE members / 630 Euro / 630 Euro / 730 Euro
● Students (non authors) (2) / 300 Euro / 350 Euro
Additional items
● Additional Conference Proceedings (20 €)
● Additional Gala dinner (100 €)

REGISTRATION FEES ...... € TOTAL

(1) To qualify for IFIP/IEEE member rates, the membership number must be provided in the registration form.
(2) Non-author students may register at Student rate. A valid student ID-card has to be provided along with the registration. Student registration fees do not include conference dinner.

Cancellation of registration

·  No refund will be made for cancellations from authors at any time.

·  In case of an emergency that prevents the original presenter from attending, the registration may be transferred to another presenter.

·  Cancellations received until April 30, 2015: full refund less 50 € for administrative costs.

·  No refund will be made for cancellations received after April 30, 2015.

·  No partial or total refunds will be made for participants who fail to attend the event.

·  All cancellations must be sent to JOUBERT VOYAGES in writing (fax or e-mail).

PAYMENT

Methods of payment:

r By credit card

r Visa r Eurocard Mastercard

Card Number:

Card holder’s name:


Expiry date (MM/YY): ____ / ____/

Billing address: ______

______

______

I hereby authorize Joubert Voyages to charge the amount of . . . . Euros to the above credit card

Date: ____ / _____ / _____ Cardholder’s signature ______

r By Bank Transfer to “Joubert Voyages” (add 15 € fee)

Bank: CIC

Agency Address: CIC Paris Mogador, 77 rue Saint Lazare, 75009 Paris

Bank Identifier Code: CMCIFRPP

International Bank Account Number (IBAN): FR76 3006 6107 4100 0104 6070 377

Account holder: SARL Joubert Voyages

A scanned copy of the bank transfer should be sent together with the registration.

The bank transfer should include the family name of the participant and “Networking2015”.

r By check payable in FRANCE -and in Euros- to “Joubert Voyages”. Send check to address below

r By French institutional order form (“bon de commande”). Send check to address below

Address to send check or “Bon de commande”:

Michele NAHUM

JOUBERT VOYAGES

18, rue de Mogador

75009 Paris