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ICCCN 2022 POSTER PAPER “AUTHOR” REGISTRATION FORM (AUTHOR REGISTRATION DEADLINE: MAY 4, 20 22. This form is NOT valid after May 11, 2022 ) ICCCN 2022 will be held virtually on July 25 - 28, 2022 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 Poster Paper # (EasyChair Paper ID #): ___________ Title:_______________________________________________________________________________________ Authors:____________________________________________________________________________________ Your First Name:________________________________ Last Name:_______________________________________ Title (Dr/Prof):_______________________Student (check one): Yes:______No:_______; Mr:______or Ms:________ Company/Univ.:_________________________________________ Dept.:____________________________________ Address:_________________________________________________________________________________________ City:___________________________________ State:____________ Zip/Postal Code:__________________________ Country:______________________________ Phone:_____________________________________________________ Fax:______________________________________ Email:_________________________________________________ AUTHOR RATE – Each POSTER Paper reg. fee payment covers one poster paper (up to two pages). The reg. form and fee payment must be received by ICCCN 2022 conference by May 4, 2022, 11:59pm EST New York time (or your poster paper may be excluded from the ICCCN2022 conference proceedings). The reg rate for each poster paper is US$200.00 (IEEE member rate; or $300 Non IEEE rate) if you have an accepted conference regular full paper and you are the registered common author of the poster and a conference regular full paper (a separate reg form for the conference full paper is required). Poster Paper Reg. Fee: _______IEEE Member (US$270) _______Non IEEE Member (US$370) If you are interested in attending both ICCCN 2022 Poster and Workshops ( without conference and workshop papers ) the reg. rate is: _______IEEE Member (US$450) _______Non IEEE Member (US$550) --------------------------------------------------------------------------------------------------------------------------------------------------- Reg. Fee from above: $ __________ (Provide your IEEE Membership # if any. See below) Add US$200.00 late fee after MAY 4, 2022 $ __________ Total Fees Enclosed US$ __________ Your Signature (required):______________________________________________ Date:_______________________ Your membership: IEEE:_____ or ComSoc:_____ (please check one) Membership #: ____________________ (Required: attach a copy of your IEEE membership card to your reg. form). The paid/registered author of any accepted paper must give a virtual presentation at ICCCN2022, or your paper will be excluded from the IEEE Xplore. We do not allow presentations by non-authors for accepted papers. *After May 4, 2022, please add US$200 late fee to the total. We cannot guarantee the inclusion of your paper in the ICCCN2022 conference proceedings/technical programs/Xplore if a reg. fee + the late fee is not received by May 11, 2020. @@@@@@@@@@ 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 icccn.register@gmail.com If you wish, you can email a password protected reg form (in doc or PDF) and email the password in a separate email. @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ Payment Method (your reg. form/fee payment MUST be received by May 4, 2022, 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 is required!! Cardholder Name (as it appears on your card):______________________________________________________________ Cardholder Signature ( required ) : ____________________________________________ Date: __________________ * SCAN in and email this form to: icccn.register@gmail.com (PREFERRED Method) or FAX this form to +1 913-660-0904 (secure and dedicated fax line for ICCCN2020) by NO LATER THAN MAY 4, 2022 (or May 11, 2022 with the late fee). ====================================================================================== ICCCN 2022 POLICY: 1. Each ICCCN 2022 (conference accepted poster paper) presenter must register at the FULL rate. Each FULL registration fee covers one Poster paper. 2. Refund Policy: NO refund of reg. fees paid by authors of any accepted papers is allowed at any case. 3. We assume that you have read all the terms, conditions, and policies stated above/posted at the ICCCN 2022 website and in this form. By signing this Reg. Form and registering for ICCCN 2022, you confirmed and agreed to all ICCCN 2022 conference and workshop Terms, Policy and Conditions. Acceptance of ICCCN policies are required to register for the conference/workshops. By submitting your registration form, you acknowledge that: I accept the ICCCN Policy, Terms and Conditions. 4. [ ] Yes, please send me IEEE Communication Society membership and event promotional materials. 5. Author Registration Transfer: Transfer of the paid registration fee by any registered author is allowed only to one of co-authors of the same accepted Poster paper. This transfer request, by email, must be received by ICCCN2022 by June 24, 2022, or there will be a late fee of US$200.00 for transfer processing and handling. One registration fee covers only one person. Registration rate difference will apply depending on the membership status of the new registrant (transferee). * Please visit our website for up-to-date program information and related activities at: WWW.ICCCN.ORG/ICCCN22/ ===== 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 icccn.register@gmail.com for instructions by no later than April 25, 2022 (we recommend that you initiate the bank wire transfer or mailing you reg form via post office mail by April 25, 2022, to meet the deadline. Otherwise, we strongly recommend that you register with a credit card to avoid the late fee as the bank wire transfer or post office mail may take 1 to 2 weeks or more from overseas). * We MUST RECEIVE your reg. form and payment by May 4, 2022, to secure your paper in the ICCCN 2022 Proceedings and Technical Program (by May 11, 2022, with US $200.00 late fee). * All payments MUST be in U.S. dollars. * A receipt (transaction charge slip) will be emailed to you after your reg. fee is charged successfully to the credit card you provided. * Registration includes: access to all ICCCN 2022 conference sessions (Conference only attendees) and workshops’ sessions (Workshops only attendees), and electronic download of the proceedings. * Each registration is valid for one person only. All who wish to attend the conference/workshop must register and pay their own reg fees. * If you have any questions on registration, contact Reg. Chair at icccn.register@gmail.com * There is NO student rate for the author who is responsible for registration for his/her accepted paper(s). * Please visit our website regularly for up-to-date program information and related VIRTUAL activities at: WWW.ICCCN.ORG/ICCCN22/ ======================================================================================
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