Registration Form of the ICCSCI 2017 (Non Presenter)

Registration form of the ICCSCI 2017 (Non Presenter)

The 2nd International Conference on

Computer Science and Computational Intelligence (ICCSCI2017)

October 13-14, 2017, Bali, Indonesia

http://socs.binus.ac.id/iccsci/

The ICCSCI 2017 will be held during October 13-14, 2017 in Bali, Indonesia. Please note that it is essential for all participants to send a completed Registration Form, and Proof of Payment to before August, 20 2017.

1. General Information

Prefix: / Male □ Female □
First Name: / Family Name:
(Photograph)
Position:
Organization or University:
Research Area:
Organization or University Address:
City: / State: / Country: / Postcode:
Telephone: / Fax: / Mobile: / Email:
Special Needs or Dietary Requirements:
□ Vegetarian □ Muslim □ Other (please specify):
3

2. Attendee Information

· We will prepare the certificate for the attendee only, either as presenter or participant)

· Each payment is for one person only

Name :
Organization:

3. Payment

Registration Fee is paid by using US Dollar or IDR Rupiah.

Categories / Registration Fee
(International) / Registration Fee
(Indonesia)
General presenter (Early bird) / 400 USD / 4.500.000 IDR
Additional submitted paper (Early bird) / 300 USD / 3.500.000 IDR
General presenter / 550 USD / 6.000.000 IDR
Additional submitted paper / 350 USD / 4.000.000 IDR
Non-presenter (Student) / 200 USD / 700.000 IDR
Non-presenter (Non-Student) / 200 USD / 1.000.000 IDR

Payment Method :

· For USD :

For USD amount Payment Method is Telegraphic Transfer ( TT ) “Full Amount”

Account number : 5270297970

Account name : Univ. Bina Nusantara

Bank name : Bank Central Asia (BCA)

Branch name : Universitas Bina Nusantara

Bank Address : Kampus II Univ. Bina Nusantara

Jl. Anggrek Cakra 10, Kebon Jeruk, Jakarta, 11530

City : Jakarta

Country : Indonesia

Swift Code : CENAIDJA

Currency : USD

· For IDR :

Account number : 5270296698