ICCCN 2017 CONFERENCE “AUTHOR” (INVITED Paper) REGISTRATION FORM
(Invited Paper AUTHOR REGISTRATION DEADLINE: MAY 10, 2017)
July 31 - August 3, 2017, Marriott Vancouver Pinnacle Downtown
PLEASE read ENTIRE REG. FORM before you complete the form!
Complete the form and email/fax it with your payment info (Please type or word process. "NO" Hand-Written Please!)
Your Paper # (EasyChair Paper ID #): ______
Title:______
Authors:______
Your First Name:______Last Name:______
Title (Dr/Prof/Mr/Ms/):______Student (check one): Yes:______No:______
Company/Univ.:______Dept.:______
Address:______
City:______State:______Zip/Postal Code:______
Country:______Phone:______
Fax:______Email:______
Invited paper AUTHOR RATE – One reduced reg. fee payment is requited for each invited paper. The reg. form and fee payment must be received by ICCCN 2017 conference by May 10, 2017 (or your paper may be excluded from the ICCCN2017 conference proceedings). Note that there is an extra page charge beyond 9 pages at US$100 per extra page up to two extra pages for EACH invited paper.
Conference Invited Paper Reg. Fee (covers one invited paper only):
______IEEE Member (US$500) ______Non IEEE Member (US$600)
If you are interested in attending both ICCCN 2017 Conference and Workshops (without workshop papers), the reg. rate is:
______IEEE Member (US$700) ______Non IEEE Member (US$800)
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Reg. Fee from above: $ ______(Provide your IEEE Membership # if any. See below)
Extra page charge (US$100.00 PER extra page
Up to TWO extra pages, beyond 9 pages): $ ______
Total number of pages in your Paper: ______
Extra Conf. Reception Tickets ($50 each): $ ______
Extra Conf. Banquet Ticket ($100 each): $ ______
Extra copy of proceedings ($60/each): $ ______(combined conf/workshop proceedings)
Add US$200.00 late fee after MAY 10, 2017 $ ______
Total Fees Enclosed US$ ______
Your Signature (required):______Date:______
Your membership: IEEE:_____ or ComSoc:_____ (please check one)
Membership #: ______(Required for member rate and must be verifiable with IEEE or ComSoc)
The paid/registered author of any invited paper must come and give a presentation at ICCCN2017 (see below for Author Reg. Transfer information), or your paper will be excluded from the IEEE Xplore. No-show papers will be included in the conference/workshop proceedings only. We do not allow presentations by non-authors for any invited papers.
* Do you need an invitation letter for Canada entry visa application? ___Yes ___No (invitation letters will be issued
only after your reg. fee is paid)
*Please let us know if you are planning to attend any of the following events (please put check marks):
July 31, 2017: Reception: Will you attend? YES___ NO___
August 1, 2017: Banquet: Will you attend? YES___ NO___
*After May 10, 2017, please add US$200 late fee to the total (if a correct amount including any extra page charge is not paid by May 10, 2017, the late fee still will be charged. We cannot guarantee the inclusion of your paper in the ICCCN2017 conference proceedings/technical programs/Xplore if a reg. fee + the late fee is not received by May 15, 2017).
@@@@@@@@@@ Preferred Registration and Fee Payment Method @@@@@@@@@@@@@@
1. SCAN your reg. form (after you fill in the credit card info and sign the reg. form) and save it in a pdf or doc file
2. EMAIL the scanned reg. form in PDF or DOC file to
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Payment Method (your reg. form/fee payment MUST be received by May 10, 2017, not postmarked by if you mail):
Credit card type (check one): VISA_____ or MasterCard______(NO Amex)
Card Number: _ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _ Exp. Date:_ _/_ _ _ _ (MM/YYYY); CVV#: _ _ _
(CVV # is Card Verification Value on the back of your card, next to card owner’s signature).
Card billing address:______, ______, ___, ____, ______, ______
street #, street name, city, state, zip/postal code, country name are required!!
Cardholder’s Name (on the card):______
Cardholder’s Signature (required): ______Date: ______
* SCAN in and email this form to: (PREFERRED Method) or
FAX this form to (913)660-0904 (secure and dedicated fax line for ICCCN17) by NO LATER THAN
MAY 10, 2017 (or May 15, 2017 with the late fee).
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ICCCN 2017 Hotel Reservation (more info is posted at the conference website):
The ICCCN 2017 has contractual obligations to fill guaranteed guest room blocks at Marriott Vancouver Pinnacle Downtown Hotel, Vancouver, Canada. Significant financial penalties will be assessed the ICCCN17 conference should the ICCCN17 conference fall short of the expected number of rooms guaranteed. By staying at the Marriott Vancouver Pinnacle Downtown Hotel, you will enjoy logistical conveniences and additional networking opportunities in valued support of ICCCN's financial obligations.
ICCCN 2017 POLICY:
1. ICCCN 2017 each invited paper presenter must register and each registration fee covers only one invited paper. Regular reg. fee payments for non-invited papers cannot be combined with any reg. fee payment for invited papers.
2. Refund Policy: NO refund of reg. fees paid by authors of any accepted papers is allowed at any case.
3. ICCCN2017 Conference and Workshops assume NO responsibility for actions of the authors/attendees or injuries sustained by them during the conference/workshops period and assume NO responsibility in connection with the attendees' participation in the conference/workshops.
4. Author Registration Transfer: Transfer of the paid registration by any author is allowed only to one of co-authors of the same accepted paper. This transfer request must be received by ICCCN2017 by June 30, 2017. One registration fee covers only one person.
We assume that you have read and agreed to all the terms, conditions, and policies stated above/posted at the ICCCN 2017 website and in this form by registering and submitting this registration form with a credit card or other form of payment by you to ICCCN 2017 conference. By signing this Author Reg. Form and registering for ICCCN 2017,you confirm that you have reviewed and agreed to all ICCCN 2017 conference and workshop Terms of Policy stated in this reg. form, in "Author Information" posted at the ICCCN 2017 website, and in the ICCCN 2017 CFP.
[ ] Yes, please send me IEEE Communication Society membership and event promotional materials.
===== Cut here before you email, fax, or mail your reg. form (please do not send/fax this page!!) ======
If you are going to register by bank wire transfer or by regular post office mail with a payment check or money
order or credit card, please contact Registration Chair as soon as possible at for instructions.
* We MUST RECEIVE your reg. form and payment by MAY 10, 2017 to secure your paper in the ICCCN 2017
Proceedings and technical program.
* All payments MUST be in U.S. dollars.
* A receipt (charge transaction receipt) will be emailed to you after your reg. fee is charged successfully to the credit
card you provided.
* All registration materials including proceedings and receipts must be picked up only at the registration desk ON
SITE at the conference (we will not mail any of these before or after the conference).
* Each registration is valid for one person only.All who wish to attend the conference must register and pay
reg fee.
* If you have any questions on registration, contact Reg. Chair at
* Please apply your Canada entry visa as soon as possible if needed (NO later than April or early May 2017).
* Please make your hotel reservation (refer to the information posted at the ICCCN2017 website).
* There is NO student rate for the author who is responsible for registration for his/her accepted paper.
* Please visit our website regularly for up-to-date program information and related activities at:
WWW.ICCCN.ORG/ICCCN17/
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