AUTHOR
REGISTRATION FORM - BICoB-2010
March 24-26, 2010
Sheraton Waikiki Hotel, Honolulu, Hawaii, USA
All registration materials must
be received by JANUARY 15, 2010 for your paper(s) to be
published in the proceedings.
Please complete this form (TYPE or PRINT)
and return before January 15, 2010.
PAPER #:
________________ Number
of Pages: _____________
FIRST Name: _________________MI
_____ LAST Name: _________________________________________
Title ( Dr
and/or Mr / Mrs / Ms ): _________Position:
________________ Organization:
_______________________
Address:
_______________________________________________________________________________
City:
___________ State/Province:
____________ Zip/Postal Code _____________ Country:
____________
Telephone: ___________________________ Fax:
____________________________________________
E-mail: ______________________________ List your areas of interest:
____________________________
PLEASE NOTE:
To
become a NEW ISCA member at this time, or if you would like
to renew your ISCA Membership for 2010, please check both the ISCA MEMBER RATE *
and
the 2010 ISCA MEMBERSHIP** boxes below when you register.
| ISCA MEMBER RATE * | $450.00 | _________ |
| NON-MEMBER | $550.00 | _________ |
| 2010 ISCA MEMBERSHIP ** | $100.00 | _________ |
| ADDITIONAL FEES: | ||
| Extra page fee (per paper): | $ 60.00 / each page | _________ |
| Additional PAPERS, if any: | 1/2 registration fee/ each | _________ |
| Additional Luncheon Ticket: | $ 50.00 / each | _________ |
| TOTAL: | _________ |
METHOD OF PAYMENT:
__Check __Money Order
__Visa __MasterCard
Payment may be made by check, International money order (in U.S. dollars drawn
on a U.S. Bank made payable to ISCA), or credit card in U. S. Dollars.
Credit Card # __ __ __ __ - __ __ __ __ - __
__ __ __ - __ __ __
__
Expiration Date ________/_______
Security Number on
Back of Credit Card ______________
Print Name as it appears on Card
______________________________
Billing Street Address
No. __________________________ ZIP CODE of
Billing
Address _________________
_________________________________________________________
(Signature
REQUIRED)
(PLEASE INDICATE YOUR CHOICE BELOW)
I plan to attend the complimentary
LUNCHEON
on March 25, 2010
¨Yes
¨
No
Special dietary requirements:
_________________________
A/V EQUIPMENT: LCD Projectors and laptops will be provided. Presenters only need to bring their presentation on CD or thumb drive. It is recommended that you bring a back-up copy of your presentation on another device with you.
AUTHOR REGISTRATION FEE: An author may register one paper at this fee. See ADDITIONAL FEES
(above) for
more than 1 registered paper.
The conference full registration fee includes refreshments during the
conference, a luncheon banquet on March 25, 2010, and one copy of the
conference proceedings.
REGISTRATION FEES ARE NON-REFUNDABLE. Please fax
your registration form to: (919) 467-3430. Please
email the signed copyright form and a brief biography of the presenter
(include picture) to isca@ipass.net or
Mary.Ann.Sullivan2@gmail.com.
Or you can mail this completed form along with
the Registration Fee, signed copyright form and brief bio with picture to:
ISCA
ATTN: Conference Registrar - BICoB-2010
975 Walnut Street, Suite 132
Cary, NC 27511-4216
EIN NO: 56-1799522
If you have any registration questions, please contact us: Telephone: (919) 467-5559; Fax: (919) 467-3430; Email: isca@ipass.net