Fifth International Conference on Pattern Recognition and Machine Intelligence (PReMI’13)

10-14 December 2013

Organized by: Machine Intelligence Unit, Indian Statistical Institute, Kolkata, India

URL:

REGISTRATION FORM

Important Notes on Registration:

Early bird registrationis effective only when the filled in registration form is received with appropriate payment by 31 August 2013.

At least one author of each papermustcomplete theregistration processat non-student rate positively by 31 August 2013 in order to ensure inclusion of his/her paper in the conference proceedings.

Students must include a letter from the Head of the Department/Dean verifying their full-time student status.

Authors with affiliation other than Indian institutions must register in US$.

In case of multiple papers by an author, each additional paper would be subjected to an additional registration charge of US$ 150 (Rs. 2,000 for authors from India).

In case of over length papers (exceeding the 6 page limit), include US$ 75 (or Rs. 1,000 for authors from India) for each additional page (maximum of two extra pages).

Payment must be made through Bank Draft or Cashier’s Cheque(drawn in favor of INDIAN STATISTICAL INSTITUTE payable at KOLKATA) or Bank Transfer using SWIFT code (for details, please check PReMI’13 website).

Registration Details:(Please tick the appropriate box(es) and fill in all Capital Letters)
Prof. Dr. Mr. Ms. / Male Female
Affiliation:
Paper # (if any) : / Title:
Address:
City: / Country: / ZIP:
Tel.: / Fax: / Email:
Passport Details: (For Non-Indian Participants)
Passport #: / Date of Issue: / Place of Issue:
Date of Expiry: / Citizenship: / Date of Birth:
Conference Registration Fees: (Please tick the appropriate box(es) and put the amount in the rightmost column)
General / Early Bird (by 31 August 2013) / `8,000 or US$500 / ` /US$
Late (after 31 August 2013) / `10,000 or US$ 600 / ` /US$
Student / Early Bird (by 31 August 2013) / `. 5,000 or US$ 300 / ` /US$
Late (after 31 August 2013) / ` 6,000 or US$ 400 / ` /US$
Industry/ Govt. / Early Bird (by 31 August 2013) / ` 10,000 or US$ 600 / ` /US$
Late (after 31 August 2013) / `12,000 or US$ 700 / ` /US$
For Each Additional Page (max. 2 pages) / (number) × / `1,000 or US$75 / ` /US$
For Each Additional Paper / (number) × / ` 2,000 or US$ 150 / ` /US$
Tutorial / Early Bird (by 31 October 2013) / ` 4,000 or US$ 250 / ` /US$
Late (after 31 October 2013) / ` 5,000 or US$ 300 / ` /US$
Workshop Registration / ` 3,000 or US$ 200 / ` /US$
Grand Total / ` /US$
Payment Details: / Bank Draft /Banker’s Cheque Bank Transfer using SWIFT Code
Number: / Dated: / /2013 / Issued by:

Date: Signature of the Participant

Mail this form along with the payment to the following address:
The Organizing Chair, PReMI’13
Machine Intelligence Unit
Indian Statistical Institute
203 B T Road, Kolkata 700108, INDIA.
Email:; ;
Tel:+91 33 2575 2044/2047
Fax:+91 33 25753035/+91 33 2578 3357 /

For Office use only

Received Date: / /2013
Registration No: PReMI’13/
Amount: Rs./US$
Receipt No. Date: