MMM 2005 Registration Form

MMM 2005 Registration Form

Fax: +61 3 92517604 / Mail: MMM 2005, Kathy Giulieri
School of Information Technology, DeakinUniversity
221 Burwood Highway, VIC 3125, Australia / Email registration inquiries:
Kathy Giulieri <>

General Details

Title / First Name / Middle Initial / Family Name
Position / Company/Institution
Address
Suburb/City / State/Prov / Post Code / Country
Phone / Fax / Email
Paper No: Special requirements (e.g. Dietary)

Registration Details

Standard Conference registration includes attendance to all sessions, a copy of the conference proceedings, lunches, morning and afternoon teas and the conference dinner as outlined in the program,

Early Registration by 30 Nov 2004 / AU$ (Inc. GST) / Amount in AU$
IEEE Member Registration / $725.00
Non-member registration / $775.00
IEEE Student Registration / $525.00
Non-member student registration / $575.00
Standard Registration
IEEE Member Registration / $825.00
Non-member registration / $875.00
IEEE Student Registration / $625.00
Non-member student registration / $675.00
Multiple Papers – Each Additional Paper / $590.00
Additional Conference Dinner ticket / $80.00
Additional page in the proceedings / $70.00
Additional copy of proceedings / $95.00
TOTAL Registration Fees

** Student registration does not include conference dinner

Accommodation Details

Important: To secure your booking, we will supply the hotel with your credit card number. No money will be deducted from your card, as you are to settle your bill on departure. If your credit card detail is not provided, one night’s tariff is still required as deposit. We prefer your Credit card details.

Please book the following accommodation:

Principal Hotel: Novotel Glen WaverleyAU$139.00 per room / night (inc GST) Conference Venue

Novotel breakfast a rate of $18.00 per person

Other close Hotel: The Waverley International Hotel AU$133.00 per room / night (inc GST)5~10 mins walk to Conference Venue (When principal(above) hotel full, then we book this hotel for you)

Check in date __ / __ / __ Check out date __ / __ / __ ETA ______

Rooms single  twin  double Non-smoking room yes  no 

Payment

Total registration fees / AUD$
One night’s accommodation tariff (If credit card number not supplied) / AUD$
TOTAL AMOUNT PAID / AUD$

Please select your method of payment:

Invoice. Please send my organization an invoice. Purchase order number is ______

(For your records, Deakin’s ABN is 56721584203. Please contact the hotel directly if you require an invoice)

Cheque. Please make payable to Deakin. Payment must be made in Australian dollars.

Visa ______MasterCard: ______(We only accept Visa or Master Card)

Credit Card Card No: _ _ _ _ / _ _ _ _ / _ _ _ _ / _ _ _ _ Expiry Date: _ _/ _ _

Cardholders Name______Cardholders Signature: ______