IEEE BIOMS 2014 REGISTRATION FORM

2014 IEEE Workshop on
Biometric Measurements and Systems for Security and Medical Applications
Rome, Italy, 17 October 2014

_________________________________________________________________________________________________ 
Last Name					First Name				Initial

_________________________________________________________________________________________________
Organization						 Street Address

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City			State/ Province 			Country				ZIP Code

_________________________________________________________________________________________________
Phone Number			Fax		 	E-mail Address 			IEEE Member Number

FOR EU citizens ONLY: ______________________________________________________________________________
		  VAT number of the institution paying the fee or personal Taxpayer Identification Number if fee is paid by the attendee

	On or before
September 12, 2014	After
September 12, 2014	
IEEE Member	120,00 euro	150,00 euro	
Non-IEEE Member	145,00 euro	185,00 euro	
IEEE Italy Sectoin Member	100,00 euro	125,00 euro	
Student IEEE Member/ IEEE Life Member	60,00 euro	
Student non-IEEE Member	70,00 euro	
Extra papers	50,00 euro/each	

Registration fees include admission to all technical sessions, coffee breaks, lunch, and one copy of the CDROM proceedings. 

One full (i.e. not student or life member) author registration will cover publication of one accepted papers. Authors are required to pay 50 euros for each additional paper.

EDAS ID numbers of the papers covered by this registration:
 1.	___________________
 2.	___________________
 3.	___________________
 4.	___________________

Registration total: ______________ euro

Signature: 			Date: 		

If this form will be sent by email, this form does not need to be signed since the email address will be considered as your signature.

PLEASE SEND THIS FORM AND THE PAYMENT RECEIPT TO: bioms2014@unimi.it