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Registration Form of IMiEJS 2012

This document contains a registration form for the IMiEJS 2012 conference to be held in Kuala Lumpur, Malaysia from June 18-20, 2012. It requests participants to submit a completed registration form, final paper, and copyright form by May 11, 2012. The form collects personal information such as name, organization, contact details, paper submission details, and requires selection of a registration fee category of either student local, non-student local, student international, or non-student international. It provides bank account details for payment of registration fees.

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Norazimah Mat Zain
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50 views1 page

Registration Form of IMiEJS 2012

This document contains a registration form for the IMiEJS 2012 conference to be held in Kuala Lumpur, Malaysia from June 18-20, 2012. It requests participants to submit a completed registration form, final paper, and copyright form by May 11, 2012. The form collects personal information such as name, organization, contact details, paper submission details, and requires selection of a registration fee category of either student local, non-student local, student international, or non-student international. It provides bank account details for payment of registration fees.

Uploaded by

Norazimah Mat Zain
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Sustainable Engineering, Science and Business for a Better Quality of Life to Meet Future Challenges

Registration form of the IMiEJS 2012


Kuala Lumpur, Malaysia. June 18-20, 2012 http://imiejs.unimap.edu.my/ Please note that it is essential for all participants to send in a completed Registration Form, Final Papers (.doc), and Copyright Form to [email protected] before May 11, 2012. PERSONAL INFORMATION First Name: NORAZIMAH Whether attend the Conference: Yes or No F Family Name: MAT ZAIN

(If you cant attend, we will send the proceeding and the receipt to you with additional charge of charge after the conference.)

Position: Professor/ Associate Professor/ Assistant Professor/ Lecturer/ Ph.D. Candidate/ Postgraduate/ etc.. Organization or University: UniMAP Detailed Post Address (Important!): Peti Surat 526, Kg terus Teritip, City: Kuala Perlis State: Perlis Country: Malaysia Postcode: 02000 Telephone: 049855607 Fax: Mobile: 0177238505 Gander : Male / Female Special Needs or Dietary Requirements: Student ID Number of Your University: 0930810439 Paper Submission No.: 196 Paper Title: Performance Evaluation of SAC-OCDMA Using Direct Detection Techniques Employing Various Codes Paper Author (s): Norazimah Binti Mat Zain Paper Pages: 5 REGISTRATION FEE Registration Fee Please tick ( ) Student International participant EURO 150 Student Local participant RM 500 Non-Student International participant EURO 250 Non-Student Local participant RM 750 ** One regular registration with one or more additional papers has only one proceeding book. Please make payment directly into our bank account below: Name of Beneficiary : BENDAHARI UNIVERSITI MALAYSIA PERLIS Acc. No. : 0901-0001234-71-0 Address : JABATAN BENDAHARI, D/A BANGUNAN TNB LAMA, PERSIARAN JUBLI EMAS, 01000 KANGAR, PERLIS, MALAYSIA Bank Name : BANK MUAMALAT MALAYSIA BERHAD Address : NO. 11 & 13, JALAN BUKIT LAGI, 01000 KANGAR, PERLIS, MALAYSIA Swift Code : BMMBMYKL
*

Email: [email protected]

Note :

The corresponding bank is Bank Muamalat Malaysia Berhad The beneficiary name is Bendahari Universiti Malaysia Perlis Please include the beneficiary name and account number. Please email the transaction/payment slip to [email protected] as a proof of payment

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