CONFERENCE REGISTRATION FORM

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Nov 3, 2013 (3 years and 7 months ago)

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UCC 2011



C
ONFERENCE REGISTRATION FORM

The preferred method of

registration is via the web at

www.cloudbus.org/ucc2011


TAX INVOICE

ABN:
66 121

965 428


Date:







This form enables you to:



register to attend the
4
th

IEEE International Conference on Utility and Cloud
Computing
;



indicate attendance and book guests for Conference
Dinner



the option to

pay for conference either by cheque, EFT or credit card

Please complete and return this form along with payment to:


4
th

IEEE International Conference on Utility and Cloud Computing( UCC 2011).

Think Business Events

Suite 6, 19
-
23 Hoddle Street, Richmond

VIC 3121

Phone: +61 3 9417 1350

Fax:
+61 3 8610 2170

Email:
ucc2011@thinkbusinessevents.com.au



Important Notes



All prices quoted are in Australian Dollars (AUD) and inclusive of Goods
and
Services Tax (GST).



By completing this registration form you have read, understood and agree
to the cancellation policies and the privacy statement as stated on this
form



Please send all four pages to conference office.



Please keep a photocopy for your rec
ord. One form per person.



Contact Details


Mr


Ms



Mrs


Mis
s


Dr


Prof.

Other (please specify)







Last Name







First Name







Organi
s
ation







Position







Address







Suburb/Town







State







Country







Postcode







Work Phone

(






)






Work Fax

(






)






Mobile







Email







Name Badge

Please indicate correct details for your name badge at the conference,
if different from above:

First Name







Last Name







Organi
s
ation







CONFERENCE REGISTRATION

Registration fee is per person

and includes attendance to conference, morning tea, lunch, afternoon tea,
Conference Dinner, CD Proceedings and
Conference Registration kit.


Registration Type

Early Bird Rate

(Up to
30
October

2011
)

Standard Rate

(After
30
October


201
1
)

Full
Registration


IEEE /ACM
Member Registration

Membership No:_____________

$
600

$
750


Non Member Registration

$
750

$
940


IEEE / ACM
Student
Member
Registration

Membership No:_____________

$4
50

$
550


Student
Non Member
Registration

$
550

$
625

TOTAL

$







$








ADDITIONAL CONFERENCE ITEMS




Early Bird Rate

(Up to
30 September
2011
)

Standard Rate

(After
30 September

201
1
)

Additional CD Proceedings


please indicate number







$50/copy







$75/copy

Extra Page Charges (for Authors Only)


please
indicate number







$100/page







$150/page

TOTAL

$






$







SOCIAL FUNCTIONS

INCLUSIVE

CONFERENCE DINNER



The
Conference Dinner
is
included

for all
DELEGATES
.



If you are attending the conference as a delegate,
you do not need to purchase a ticket for yourself. However, please indicate if you will be attending for
catering purposes.

For more information about the social functions please visit the website

Conference Dinner


,


7 December 2011


Yes

No

Maybe (I will confirm by no later than

1 November 2011
)

ADDITIONAL
FU
NCTION TICKETS FOR
PARTNER /GUEST

Conference Dinner:

I would like to purchase






tickets at
AUD $
75

(incl. GST) = $








MEAL

Please note that conference is providing vegetarian food (of various types including Italian and Indian).




UCC 2011


PAYMENT

All payments must be made in Australian Dollars only and must include the GST component.
Charges paid by credit card will appear as “Think
Business Events Pty Ltd” on your credit card statement.


Please transfer all sub totals from the sections above and
check your calculations carefully.

Payment Summary

Conference Registration

$







Additional Conference Items

$







Additional
Conference Dinner

$







TOTAL

$







Method of Payment

All amounts in this brochure are in Australian dollars (AUD$) and include 10% Goods and Services Tax (GST).


Cheque

Cheques / bank transfers payable in AUD$ to “
-

Think Business Events ATF
UCC


Bank Draft

Bank Details BSB


085 604

Acc


197636087


When sending a bank transfer, please send a remittance advice to the conference office via email to
ucc2011
@thinkbusinessevents.com.au

or by fax to 03 8610 2170


Credit Card


Visa



MasterCard


Diners


American Express.

Card Holder Name







Card Number


























Expiry Date







/






Signature



TERMS & CONDITIONS

Privacy Statement

4
th

IEEE International Conference on Utility and Cloud Computing
(the conference) and Think Business Events is bound by, and committed to supporting,
the National Privacy Principles (NPPs) set out in the Privacy Amendment (Private Sector) Act 2000.


The inf
ormation that you provide in the Registration form and information provided at any other time during the Conference, includin
g without limitation any
feedback obtained during the Conference, will be used by the Conference to offer, provide and continue to
improve its Conferences and other services.
The Conference may disclose some of the information that is collected in the Registration Form such as your name, organisatio
n and its location and your
email address to other Conference delegates and (unless yo
u object in writing to us) to Conference sponsors and exhibitors for marketing purposes.


The Conference will not otherwise, without your consent, use or disclose your personal information for any purpose unless it
would reasonably be expected
that such pu
rpose is related to the offer, provision and improvement of the Conference or where such purpose is permitted or required by
law.


Registration
-

Conditions


Cancellation Statement:
No refund will be made for
cancellation of registration.

Transfer of
registration
: Transfer of your registration (non
-
author participant) 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 the Conference.

Non
-
attendance:

No refunds will be made for non
-
attendance at the Conference.




I have read and understood the terms & conditions.

Signature: _________________________________
_____________