ICCCN 2022 POSTER PAPER “AUTHOR” REGISTRATION FORM
                  (AUTHOR   REGISTRATION     DEADLINE:   MAY 4, 20  22.   This form is   NOT valid after May   11, 2022  ) 
                                                   ICCCN 2022 will be held virtually on July 25 - 28, 2022
          PLEASE read ENTIRE REG. FORM before you complete the form!
          Complete the form and email/fax it with your payment info (Please type or word process. "NO" Hand-Written Please!). 
          Your Poster Paper # (EasyChair Paper ID #): ___________
                   Title:_______________________________________________________________________________________
                   Authors:____________________________________________________________________________________
          Your First Name:________________________________ Last Name:_______________________________________
          Title (Dr/Prof):_______________________Student (check one):  Yes:______No:_______; Mr:______or Ms:________
          Company/Univ.:_________________________________________ Dept.:____________________________________
          Address:_________________________________________________________________________________________
          City:___________________________________ State:____________ Zip/Postal Code:__________________________
          Country:______________________________ Phone:_____________________________________________________
          Fax:______________________________________ Email:_________________________________________________
          AUTHOR RATE – Each POSTER Paper reg. fee payment covers one poster paper (up to two pages). The reg. form and 
          fee payment must be received by  ICCCN 2022 conference by   May 4, 2022, 11:59pm EST New York time  (or your 
          poster paper may be excluded from the ICCCN2022 conference proceedings). The reg rate for each poster paper is 
          US$200.00 (IEEE member rate; or $300 Non IEEE rate) if you have an accepted conference regular full paper and you
          are the registered common author of the poster and a conference regular full paper (a separate reg form for the conference 
          full paper is required).
           
          Poster Paper Reg. Fee:
                                                      _______IEEE Member (US$270)                   _______Non IEEE Member (US$370)
           
          If you are interested in attending both ICCCN 2022  Poster and Workshops     (  without   conference and workshop papers ) 
          the reg. rate is:
                                                       _______IEEE Member (US$450)                   _______Non IEEE Member (US$550)
          ---------------------------------------------------------------------------------------------------------------------------------------------------
          Reg. Fee from above:                                            $ __________ (Provide your IEEE Membership # if any. See below)
          Add US$200.00 late fee after MAY 4, 2022        $ __________
                                                 Total Fees Enclosed US$ __________
          Your Signature (required):______________________________________________  Date:_______________________
          Your membership: IEEE:_____ or ComSoc:_____ (please check one) 
          Membership #: ____________________ (Required: attach a copy of your IEEE membership card to your reg. form).
          The paid/registered author of any accepted paper must give a virtual presentation at ICCCN2022, or your paper 
          will be excluded from the IEEE Xplore. We do not allow presentations by non-authors for accepted papers.
          *After May 4, 2022, please add US$200 late fee to the total. We cannot guarantee the inclusion of your paper in the 
          ICCCN2022 conference proceedings/technical programs/Xplore if a reg. fee + the late fee is not received by May 11, 2020.
          @@@@@@@@@@    Preferred Registration and Fee Payment Method    @@@@@@@@@@@@@@
            
          1. SCAN your reg. form (after you fill in the credit card info and sign the reg. form) and save it in a pdf or doc file
          2. EMAIL the scanned reg. form in PDF or DOC file to icccn.register@gmail.com
       If you wish, you can email a password protected reg form (in doc or PDF) and email the password 
       in a separate email.
       @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@
       Payment Method (your reg. form/fee payment MUST be received by May 4, 2022, not postmarked by if you mail):
       Credit Card type (check one):   VISA_____ or   MasterCard______    (NO Amex)
       Card Number:  _ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _ Exp. Date: _ _/_ _ _ _ (MM/YYYY); CVV#: _ _ _
                                                                                                                     (CVV # is Card Verification Value on the back of your card, next to card owner’s signature).
       Card Billing Address: _____, _________, ___, ____, ____________, ___________
                                           street #, street name, city, state, zip/postal code, country name is required!!
       Cardholder Name (as it appears on your card):______________________________________________________________
       Cardholder Signature (  required  ) : ____________________________________________ Date: __________________
       * SCAN in and email this form to:  icccn.register@gmail.com (PREFERRED Method) or
          FAX this form to +1 913-660-0904 (secure and dedicated fax line for ICCCN2020) by  NO   LATER  
       THAN  
          MAY 4, 2022 (or May 11, 2022 with the late fee).
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       ICCCN 2022 POLICY:
       1. Each ICCCN 2022 (conference accepted poster paper) presenter must register at the FULL rate. Each FULL 
       registration fee covers one Poster paper.
       2. Refund Policy: NO refund of reg. fees paid by authors of any accepted papers is allowed at any case.
       3. We assume that you have read all the terms, conditions, and policies stated above/posted at the ICCCN 2022 
       website and in this form. By signing this Reg. Form and registering for ICCCN 2022, you confirmed and agreed to all 
       ICCCN 2022 conference and workshop Terms, Policy and Conditions. Acceptance of ICCCN policies are required to 
       register for the conference/workshops.
       By submitting your registration form, you acknowledge that:
        
         I accept the ICCCN Policy, Terms and Conditions. 
       4. [   ] Yes, please send me IEEE Communication Society membership and event promotional materials. 
       5. Author Registration Transfer: Transfer of the paid registration fee by any registered author is allowed only to one of 
       co-authors of the same accepted Poster paper. This transfer request, by email, must be received by ICCCN2022 by June 
       24, 2022, or there will be a late fee of US$200.00 for transfer processing and handling. One registration fee covers only 
       one person. Registration rate difference will apply depending on the membership status of the new registrant (transferee).
       * Please visit our website for up-to-date program information and related activities at: 
       WWW.ICCCN.ORG/ICCCN22/
    ===== Cut here before you email, fax, or mail your reg. form ( please   do     not   send/fax   this page  !! ) ======
    If you are going to register by bank wire transfer or by regular post office mail with a payment check or money 
    order or credit card, please contact Registration Chair as soon as possible at icccn.register@gmail.com for instructions 
    by no later than April 25, 2022 (we recommend that you initiate the bank wire transfer or mailing you reg form via post 
    office mail by April 25, 2022, to meet the deadline. Otherwise, we strongly recommend that you register with a credit card
    to avoid the late fee as the bank wire transfer or post office mail may take 1 to 2 weeks or more from overseas).
    * We MUST RECEIVE your reg. form and payment by May 4, 2022, to secure your paper in the ICCCN 2022 
        Proceedings and Technical Program (by May 11, 2022, with US $200.00 late fee). 
    * All payments MUST be in U.S. dollars. 
    * A receipt (transaction charge slip) will be emailed to you after your reg. fee is charged successfully to the credit 
       card you provided. 
    * Registration includes: access to all ICCCN 2022 conference sessions (Conference only attendees) and workshops’ 
       sessions (Workshops only attendees), and electronic download of the proceedings.
    * Each registration is valid for one person only. All who wish to attend the conference/workshop must 
       register and pay their own reg fees.
    * If you have any questions on registration, contact Reg. Chair at icccn.register@gmail.com
    * There is NO student rate for the author who is responsible for registration for his/her accepted paper(s).
    * Please visit our website regularly for up-to-date program information and related VIRTUAL activities at:
                                                                   WWW.ICCCN.ORG/ICCCN22/
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