International Federation for Information Processing

ICWL 2013Non-Author Registration Form Page 1

The 12thInternational Conference on Web-Based Learning (ICWL) 2013

October6 - 9, 2013, Kenting, Taiwan

To register, please fill in the forms for Registrant Information and Registration Fee on Page 2 and pick up your preferred option on Page 3 for the transfer of your registration fee from the following two alternatives:

1. Pay by credit card in NT$

Thenscan the completed Registration Form (Page 2 and Page 3) into PDF file, and email it to .

1. Pay by bank transfer in US$

Then scan the completed Registration Form (Page 2) and the receipt for the transfer from your bank into PDF file, and email it to .

For paper authors, please set the subject of the email to be “[Paper ID]: [Conference/Workshop] Registration”. For non-paper authors, please set the subject of the email to be “Participant’s Registration”.

If you have any questions regarding to payment or registration, you may contact Mr. Chung-ChunLin ()

DISCLAIMER: Web Intelligence Consortium(WIC) is only helping handle the participants’ registrations for ICWL 2013. It is not responsible for lost or stolen credit card information. Registration is not guaranteeduntil payment is received.

Full Registration includes admission to all conference and workshop sessions, welcome reception, coffee breaks, lunches, a local tour, a banquet and a round-trip transportation between Kaohsiung and Kenting.

Note that:

1. For non-paper authors, you need tomake the full registration by July29, 2013.
2. Once we have processed your signed registration form, we will send you an email to confirm your registration status and the total amount that we have charged you, provided that the email address you put down in the registration form is functioning.
3. You can pick up the official receipt for the registration during the conference.

The 12thInternational Conference on Web-Based Learning (ICWL) 2013

October6 - 9, 2013, Kenting, Taiwan

Registrant Information

Paper ID: Non-Paper Paper Type: ▓Conference ▓Workshop

Paper Title: Non .

Title: □Prof. □Dr. □Mr. □Ms. □Miss

First Name: ______Last Name: ______

Cell phone:______Fax: ______Email: ______

Affiliation: ______Country: ______

Receiver of receipt: ______

□vegetarian. □special dietary requirements: ______

Attendance of the free Local Tour, Oct.8(from 13:00 to 21:30): □Yes, I will □No, Thanks

Transportation options for Free Shuttle Bus:

From Kaohsiung Zuoying THSR Station to H Resort (Arrival):

Date: □Oct.5 □Oct.6 □Oct.7 □Oct.8

Time: □12:15 □16:00

□No, Thanks

From H Resort to Kaohsiung Zuoying THSR Station (Departure):

Date: □Oct.6 □Oct.7 □Oct.8 □Oct.9

Time: □10:30 □14:15 □ 18:30(Oct. 9 only)

□No, Thanks

Registration Fees

The 12thInternational Conference on Web-Based Learning (ICWL) 2013

October6 - 9, 2013, Kenting, Taiwan

Payment

□Option 1: Pay by Credit Card in NT$

Please PRINT CLEARLY the credit card information.

Paper ID: Non-Paper .

Card Holder’s Name: ______Card Type: □ Visa □MasterCard

Card No. : ______/______/______/______

CVV/CVC (the 3 or 4 digit code on the back panel of your Visa/MasterCard) : ______

Card Expiry Date: (month) ______/ (year) ______

The country and bank which provides Credit card: ______

Total Payment ((NT$): ______

Card Holder’s Signature: ______

□Option 2: Pay by Bank Transfer in US$

Please refer to the following account information for Bank Transfer in US$:

Beneficiary Account Name: Ubiquitous International LLC.

Beneficiary Account No.: 534-851233-838

Beneficiary Bank name: MONG KOK Branch, HSBC HONG KONG

Beneficiary Bank address: 1 Queen's Road Central, Hong Kong

Swift Code: HSBCHKHHHKH

Bank Code: 004 (optional)

Please have “ICWL-2013” and your paper ID included in the annotation for your transfer. Please also notice that the processing fee for bank transfer must be paid by the sender.