Date: 2016
This formenablesyouto: / Importantnotes
Register to attend ICESNANO 2016 / All conference fees quoted are in USD or IDR
Indicate attendanceConference /  By completing this registration form you haveread,
Payfortheconference / Understoodandagreedtotheregistrationpoliciesandthe
privacy policy as stated on this form and the website
 Pleasesend all pages to conferenceofficialemail:
Please complete, scan, and email this form along with proof ofpayment (pdf format) to:
Email : /  Please keep a photocopy foryourrecord
 One registration form perperson
Contact Details
Title / Mr / Ms / Mrs / Miss / Dr / Prof / Other (pleasespecify) :
Fullname
Conference Registration /  Author /  Author student /  Non author praticipant
PaperTitle(Author)
(Separate with semicolon (;) if you have multiple papers)
Submission ID
(Separate with semicolon (;) if you have multiple papers)
Affiliation(your institution)
Full Work Address
City
State / Country / Postal code
Phone / ( )- / Fax. / ( )- / Mobile
Email
Conference Registration
Registration fee is per person and includes attendance to the conference, morning tea and lunch, welcome dinner, and conference kits.
Registrationtype / Early birdrate
(Before July 10th 2016) / Normal rate
(After July 10th 2016)
International Participants
Author (full registration) / USD 450 / USD 500
Author student registration / USD 350 / USD 400
Non author praticipant/co-author/accompanying person / USD 75 / USD 75
Additional papers (each) / USD 250 / USD 275
LocalParticipants
Author (full registration) / IDR2.500.000 / IDR2.750.000
Author student registration / IDR2.250.000 / IDR2.500.000
Non author praticipant/co-author/accompanying person / IDR350.000 / IDR350.000
Additional papers (each) / IDR1.250.000 / IDR1.500.000
City tour (optional)
Ifyou wish to follow city tour / IDR100.000
Workshop Registration(optional)
Registration fee is per person and includes attendance to the conference, morning tea and lunch, welcome dinner, and conference kits.
Workshop / External / Internal
Manufacturing and Testing of natural dye-sentitized solar / IDR2.500.000 / IDR1.750.000
Syntheziednanofibre for piezoelectric / IDR1.500.000 / IDR1.500.000
Thermal analysis of solid particles and thermal conductivity / IDR1.000.000 / IDR1.000.000
TermsConditions
1.After having completed the registration procedure,you have to proceedthe registrationfeeonly by using bank transfer payment.
Please transfer the registration fee to:
SUKMAJI INDRO CAHYONO
Bank BNI, Acc. No. 0420485408
Swift code BNINIDJAXXX
2.Studentswho will attend the conference can register and pay the student registration fee. Please send a scanned copy (pdf file) of your certification as a student with name/affiliation/emailaddress and signature of your supervisor, to:
Email :
Subject : Student-Reg ICESNANO2016.
You will be asked to present the original copy of your certification at the registration desk.
3.ICESNANO 2016 conference fees coverattendance of Conference Delegates to the sessions of the conference, conference kits, all conference lunches, all coffee breaks, welcome reception, banquet dinner, and Open Access Publication at AIP (American Institute Physics) Conference Proceedings.
4.IMPORTANT REMINDERS:
  1. The bank transferand other relatedfees have to be paid by the Conference Delegates.
  2. Theconference committee isnotresponsibleforadditionalbankchargesandtransferfees.
  3. After sending your registration payment by bank transfer, scan the bank receipt and attach the PDF file in an email to:
Email :
Subject : Payment LASTNAME (your abstract submission ID number(s))
(Note: Fill in LASTNAME with your sure name or family name, so that we will be able to monitor your payment with your registration entry)
5.Transfer of your registration to another person is acceptable. The full name and details of the person that will replace you must be advised in writing to the conference office prior to theconference.
6.Any accepted paper included in the final proceedings is expected to have at least one author to attend and present the paper at the conference. Accepted papers that arenotpresented(“non-attendance”papers)willnotbeincludedinthefinalconferenceproceedings.It is noted that no refunds will be made for non-attendance at theconference.
7.All online publication fees are completely independent of the number of pages in your proceedings papers. All contributions must be full articles with a preferred minimum of 4 (four) papers per paperwithout extra chargeforeachpaper.
8.To qualify for early bird registration, registration fees must be received before 10 July 2016.
Privacy Policy
1.Collection of your Personal Information
The conference committees will collect personally identifiable information in registration form, such as yourname, e-mail address,work address, and telephone number.
2.Use of your Personal Information
Your Personal Information is collected for conference need such as to registeryour attendance at the conference; assist with administrative and planningpurposes; plan and develop conferences and other events in thefuture; facilitate your requirements in relation to the workshop and the conference;and allow the compilation and analysis of statistics relevant to theconference.
3.Security of your Personal Information
The conference committees secureyour personal information from unauthorized access, use or disclosure. The conference committees securethe personally identifiable information you provide on computer servers in a controlled, secure environment, protected from unauthorized access, use or disclosure.
4.Disclosure of personal information to thirdparties
This Privacy Policy applies solely to the personal data collected by ICESNANO 2016.The conference committeesdo not apply to third party websites except the designated third party that is, AIP Conference Proceedings website. ICESNANO 2016 is not responsible for the privacy policies of the mentionedthird party website.
5.Contact Information
ICESNANO 2016 welcomes your comments regarding this Privacy Policy. If you believe that the conference committees have not adhered to this Privacy Policy,please contactICESNANO .
I have read and understood the termsconditions.Signature: