DETAILS OF PARTICIPANT Name: Designation : Email: Organization: Address : City:

Postal Code :

Country : Tel. No. :

Fax No. :

Mobile No. : Title of Paper:

Meal Preference

£ Vegetarian

£ Non-vegetarian

REGISTRATION AND WORKSHOP FEES (Please tick) CONFERENCE Category

Fee (Early Bird)

Fee (After 5 September 2017)

£ Local Participant

RM 1200.00

RM 1600.00

£ Overseas Participant

USD 650.00

USD 800.00

MITS, IEEE and ACM Member £ Local Participant

RM 1280.00

£ Overseas Participant

USD 640.00 WORKSHOP

£ Local Participant

RM 400.00

£ Overseas Participant

USD 150.00 WORKSHOP - FOR MITS, IEEE AND ACM MEMBER

£ Local Participant

RM 320.00

£ Overseas Participant

USD 120.00

Important Notes 1. An author of each accepted paper(s) is required to register and make full payment for their paper(s) before 5 September 2017 in order to ensure their paper(s) to be published in the proceeding. 2. Please email the registration form together with the proof of payment to [email protected] 3. There is no refund for cancellation. Mode of Payment Please choose one of the mode of payment below:

o

Bank Draft/Money Order No:________________ Payable to “Bendahari UKM”

OR

o

AKAUN CIMB ISLAMIC UNIVERSITI KEBANGSAAN MALAYSIA (8002234307) Company Name

: Universiti Kebangsaan Malaysia

: Jabatan Bendahari, Universiti Kebangsaan Malaysia, Bangi, 43600 Selangor Darul Ehsan Company Registration Number : PU (A)105 Bank Account Name : UNIVERSITI KEBANGSAAN MALAYSIA Bank Account Number : 8002234307 Swift Code : CIBBMYKL Bank Branch : CIMB ISLAMIC BERHAD CAWANGAN UNIKEB : Lot 1.04 &1.05, Level 1 Bank Address Wisma UNIKEB, UKM 43600 UKM, Bangi, Selangor Company Email : [email protected] No. Tel : 03-8921 3000 No. Fax : 03-8925 3058 Company Mailing Address

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