Address: Unit B, 6/F, Dragon Industrial Building, 93 King Lam Street, Lai Chi Kok, Kowloon, Hong Kong, Email:

Tel: +852-3500-0137 (Hong Kong)/+1-206-456-6022 (USA)/+86-28-86528465 (China)

Listener Registration form of ICNB 2017

Amsterdam, Netherlands, December 11-13, 2017

http://www.icnb.org/

2017 International Conference on Nanomaterials and Biomaterials (ICNB 2017) will be held in Amsterdam, Netherlands during December 11-13, 2017. Please note that it is essential for all participants to send in a completed Registration Form and Payment Proof to before November 10, 2017.

1.  PERSONAL INFORMATION

First Name: / Family Name: / Attendee’s Photo
Whether attend the Conference: (Please choose √)
Yes □
The Attendee’s Name:
(All the materials of participation will be prepared under this name. Only one participant could come with one registration.)
No □
Detailed Post Address:
(We will send the registration receipt to you free of charge after the conference.)
Whether join in the One Day Visit on December 13, 2017, 80 USD/per person (Please choose √)
Yes □ The Attendee’s name:
No □
Position: Prof. □ Associate Prof.□ Assistant Prof.□ Lecturer□ Ph. D □ Master □ Others □
Organization or University:
City: / State: / Country: / Postcode:
Telephone: / Fax: / Mobile: / Email:
Special Needs or Dietary Requirements:
Student ID Number of Your University:

Any enquiries or questions please feel free to contact us for assistance.

2.  REGISTRATION FEE

Registration Fee / Please fill√
Listener / 300 USD
One Day Visit & Tour / 80 USD
Proceedings/Journal / 50 USD/One Book

* For the participants who have difficulties to pay US Dollars, such as Iran, you can pay by Euros.

3.  PAYMENT INFORMATION

A.  Credit Card Payment Information (No handling fees)

http://meeting.yizhifubj.com.cn/web/main.action?meetingId=188

Please make sure you have VISA or Mastered Card Credit Card before clicking this link, and you should also calculate the right amount and pay.

Please fill in the E-mail and Confirmation Number after paying.

E-mail: / Confirmation Number:

B.  Bank Transfer (30 USD handling fees)

ACCOUNT NUMBER: 779 053 099 668

ACCOUNT NAME: ZHOU JIANHONG

NAME OF THE BANK: HANG SENG BANK LIMITED

SWIFT CODE: HASEHKHH

ADDRESS OF THE BANK: 83 DES VOEUX ROAD CENTRAL, HONGKONG

Please fill in the following form for us to check your payment

Remitter’s Account No.
Remitter’s Name:
Remit date:
Remit amount:

Please indicate paper ID as “listener” in the payment, and return the filled registration form and scanned payment proof to before November 10, 2017 by e-mail attachment.

ICNB 2017

- 2 -