REGISTRATION FORM
Title
: (Prof/Assoc Prof/Dr/Sir/Mr/Ms)
Full Name
:
Organization
:
Address
:
Postcode
:
City:
State:
Telephone
:
Mobile:
Fax:
E-mail
:
Paper No
:
Category
:
Local
Student
Conference as
:
Paper Presenter
Attend Conference:
Alternate E-mail:
Paper Title:
:
Attend
Local
Participant
International
Student
Participant Only
International
Participant
Session Chair:
Interested
Not Interested
Not Attend
Name to be printed on IC-ITS 2015 certificate:
Fees: Please thick/remark the check box for your chosen package.Early bird for this
conference is 30th April 2015
NORMAL FEES
NORMAL FEES
PACKAGE
ADDITIONAL PAPER
(after early bird)
(early bird)
NORMAL RATE
STUDENT RATE
(Please email your student ID)
PARTICIPANT/LISTENER
USD 200
(MYR 650)
USD 175
(MYR 550)
USD 175
(MYR 550)
USD 175
(MYR 550)
USD 150
(MYR 450)
USD 150
(MYR 450)
* Conference Fee comes with 1 lunch and 2 coffee breaks for days 2 days (no hotel room provided with the fee)
* All transaction in MYR base on ~ 3.5 exchange rates with service charges
* Additional paper is chargeable at USD75 per paper – Please visit the website for the online payment link
* For student package, please email your Student ID for verification purpose
Faculty of Information Science and Technology
Selangor International Islamic University College, Bangi,
43000 Kajang, Selangor, Malaysia. WhatsApp: +6012-3323410
Conferences E-mail: [email protected] web: http://fstm.kuis.edu.my/icits/
USD 75
(MYR 250)
USD 75
(MYR 250)
NIL
Payment Method:
Payment Option #1 (via Telegraphic Transfer or Direct Deposit)
Made payable to:
Account number : 12-0290-1007-0696
Account name : FAKULTI SAINS DAN TEKNOLOGI MAKLUMAT KUIS
Bank: BANK ISLAM (M) BERHAD
Bank Address: BANK ISLAM (M) BERHAD, CAWANGAN BANDAR BARU
BANGI, SELANGOR
Swift code: BIMBMYKL – Bank Islam Malaysia Berhad
Payment Option #2 (via Banker’s Cheque or Bank Draft)
Made payable to:
Account number : 12-0290-1007-0696
Account name : FAKULTI SAINS DAN TEKNOLOGI MAKLUMAT KUIS
Bank: BANK ISLAM (M) BERHAD
Bank Address: BANK ISLAM (M) BERHAD, CAWANGAN BANDAR BARU
BANGI, SELANGOR
Swift code: BIMBMYKL – Bank Islam Malaysia Berhad
Please mail the transaction slip or bank slip after the payment has been made to:
mail: [email protected]
Please mail the registration form to:
mail: [email protected]
Cancellation Policy
Substitution is allowed for registered participants. Please note that payment must be made prior or before to
the early bird due date to qualify for discount. Cancellation policy will be imposed if cancellation is made by:
1. Cancellation before 6 weeks of the event 100%
2. Cancellation less than 5 weeks of the event 50%
3. Cancellation less than 2 weeks of the event – sorry, no refund
Registration Fee Detail
Registration fee must be paid in advance of the event. Walk-in delegates, with payments will be
admitted on space availability basis.
ACCOUNT INFORMATION DETAIL
Account number : 12-0290-1007-0696
Account name : FAKULTI SAINS DAN TEKNOLOGI MAKLUMAT KUIS
Bank: BANK ISLAM (M) BERHAD
Bank Address: BANK ISLAM (M) BERHAD, CAWANGAN BANDAR BARU BANGI, SELANGOR
Swift code: BIMBMYKL – Bank Islam Malaysia Berhad
Faculty of Information Science and Technology
Selangor International Islamic University College, Bangi,
43000 Kajang, Selangor, Malaysia. WhatsApp: +6012-3323410
Conferences E-mail: [email protected] web: http://fstm.kuis.edu.my/icits/