ICUWB 2017 .- IEEE International Conference on Ubiquitous Wireless Broadband

12/15 September, 2017 Salamanca, Spain

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Registration Form

ONLY FOR ALREADY REGISTERED USER

When you register you will receive a registration code and a password that should be used if you wish to register a Guest/Accompanying Person, or in some TUTORIAL or purchase extra tickets for the Gala Dinner in the future.

Complete the following fields and click COMPLETE DATA to register a Guest/Accompanying Person, or in some TUTORIAL or purchase extra tickets for the Gala Dinner.

Registration Code

Password:

PERSONAL DATA

Mr. Ms.

First Name:

Family Name:

Identity document:

Number:

Nationality:

Date of birth:

Format: dd/mm/yy

Personal Address:

Zipcode:

City/Town:

Province / Country:

State:

Tel.:

Fax:

E-mail:

Repeat E-mail:

Institutional affiliation - Department Company:

Title (Dr/Prof/Student):

Terms:

Regarding the L.O.15/1999 law of December 13, which deals with the treatment of personal information and databases, we would like to inform you of the following:
 
 A.- The data provided by the user will be added to a database which is kept, owned and managed by Congresual SLL, and Congresual SLL the responsible party for any use of such information. The fiscal information of Congresual SLL is: CIF B-37495116 and address: C/ Camelias 470 .  CP 37449  Galindo y Perahuy (Salamanca). The database is being registered in the General Register for Databases and it has the required code, which is assigned by the Spanish Data Protection Agency.
 
 B.- Congresual SLL guarantees the confidentiality of all the information provided by the user. The obtaining and management of the data is done following strict levels of security apart from the levels required by law in order to assure that such confidential information may not be lost nor obtained by a third party.
 
 C.- Following the current legislation, all users of Congresual SLL Server have the right to enter, modify or cancel his/her personal data. If the user chooses to cancel the personal information previously given to Congresual SLL, after the user logs off, all confidential information will be erased from the system, except information related to historical or statistical purposes.
 
 In order to modify the previously mentioned information, the user must do so in writing, by sending a formal allowance to Congresual  by regular mail to the following address:
 
 Congresual SLL, C/ Camelias 470 .  CP 37449  Galindo y Perahuy (Salamanca)

I have read and I agree the terms that appear in this registration form

Required fields

INVOICE DETAILS (if different than the above)


Initially the invoice will be fill in with the information provided in this registration form. If you need any change in your invoice, please use the box below:

Institution Name:
Institution Address:
Zipcode:
City/Town:
Province:
State:
VAT Number

Please, you should complete the Identity Document or the Vat Number for your invoice.

TYPE OF REGISTRATION

Before July 23rd, 2017

After July 23rd, 2017

Regular Registration – IEEE Member (1)

550,00 €

685,00 €

Regular Registration – Nonmember

620,00 €

775,00 €

Student Registration – IEEE Member (1) (2)

315,00 €

395,00 €

Student Registration - Nonmember (2)

355,00 €

445,00 €

Guest/Accompanying Person

225,00 €

Tutorial – IEEE Member

150,00 €

180,00 €

Tutorial – NonMember

185,00 €

225,00 €

Tutorial – Student IEEE Member

100,00 €

150,00 €

Tutorial – Student Registration NonMember

125,00 €

185,00 €

Extra Gala Dinner ticket

85,00 €

Additional page (2 pages max.)

75,00 €

-Regular and Student registration fees include lunches, coffee breaks and social programme.
-Guest/Accompanying Person registration fee includes lunches and social programme.
(1) IEEE Members must provide proof of their status with a copy of their IEEE card sent with the registration form. The document has to be presented when collecting the documentation.
(2) Students must provide proof of their status with a copy of their student card sent with the registration form. The document has to be presented when collecting the documentation.

CONTRIBUTION

Each regular registration covers two contributions.
Each student registration covers one contribution.
The registration fee cover 5 pages for contribution. The fee of each additional pages (up to 7) is 75€.

I DO NOT SUBMIT ANY CONTRIBUTION

1^st CONTRIBUTION (Included - Regular & Student registration)

Id:

Nº Additional Pages (1 or 2)

Title:

€75 for each additional page (Up to 7)

Authors:

2^ndCONTRIBUTION (Included - Regular registration)

Id:

Nº Additional Pages (1 or 2)

Title:

€75 for each additional page (Up to 7)

Authors:

TUTORIALS

TUT #01-mmWave

TUT #02-Navigation

SOCIAL ACTIVITIES

	Units	Price
Extra Gala Dinner ticket		85,00 €

ADDITIONAL INFORMATION – Food intolerances

Vegetarian

Strict vegetarian

Celiac

No pork

Other

HOW TO PAY

Bank Transfer

Bank transfer for FUNDACION GENERAL DE LA UNIVERSIDAD DE SALAMANCA payable to SANTANDER CENTRAL HISPANO

ACCOUNT NUMBER: 0049 1843 43 2410186765
IBAN: ES32 0049 1843 4324 1018 6765
BIC/SWIFT CODE: BSCHESMM
CONCEPT OF PAYMENT: ICUWB NAME + LAST NAME
ISSUE EXPENSES: BY THE PAYER

Attach a copy of the transfer to this newsletter indicating the concept of payment by email to the mailbox: registrationicuwb@congresual.com

Only VISA or MasterCard Credit Cards

You will be transferred directly to the secure on-line payment (directly with the bank).
This process will be done through the secure area of the bank.
This is an automatic process. If you have any problem, please contact with your bank.

VALIDATION CODE

Validation Code:


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