5th joint IFIP Wireless and Mobile Networking Conference 
WMNC 2012	
	  		            REGISTRATION FORM
September 19th-21st, 2012
Bratislava, Slovakia

SECTION 1: PERSONAL DETAILS
Name                                                                                                                                                                                                                                       _  
IEEE MEMBER #                                        IFIP MEMBER #                                    Organization  					              _
Address                                                                                                                                                                                                                                   _
City                                              		               Country                                                                       Postcode                                              _
Telephone                                                      Fax                                                                            Mobile                                                                            _
Email                                                                                    Special Disability / Dietary Requirements                                                                                  _

SECTION 2: PAPER(S) DETAILS
Recall that all papers must be presented by one of the authors and that each registered author may present one paper. One additional paper may also be accepted if space permits, but will incur a supplemental publication fee of 100 Euro. 
We require registration for every paper to be scheduled for presentation and published in the Conference proceedings. The non-refundable registration fee of the presenting author is required by August 1st, 2012.
Registration of PAPER NUMBER: _______________________
Registration for ONE ADDITIONAL PAPER NUMBER: _______________________
Final paper(s) converted or checked by using IEEE PDF eXpress: □ YES □ NO

SECTION 3: CONFERENCE REGISTRATION / TAX INVOICE (All fees are quoted in EURO inclusive of VAT)
Please indicate registration category:
	Early/Late conference registration (before/after July 20th, 2012)		  		  EUR 500/600	EUR                          _
	Early/Late conference registration for IEEE/IFIP MEMBER (before/after July 20th, 2012)
			IEEE/IFIP MEMBER MUST PROVIDE MEMBER NUMBER IN SECTION 1	  EUR 400/500	EUR                          _
	Early/Late registration of student participant (before/after July 20th, 2012)			  EUR 150//180	EUR                          _
	Early/Late registration of virtual presentation (before/after July 20th, 2012)			  EUR 270/300	EUR                          _
	Additional paper									  EUR 100	EUR                          _
	TOTAL AMOUNT SECTION 3									EUR  _____________

SECTION 4: SUMMARY OF PAYMENTS

TOTAL PAYMENT TO BE CHARGED 									EUR _____________
	____________________________________________________________________________________________________
All payments are to be made in EURO. All rates quoted include VAT.

		  					  Signature_______________________________________________________

5th joint IFIP Wireless and Mobile Networking Conference 
WMNC 2012	
	  		            REGISTRATION FORM
September 19th-21st, 2012
Bratislava, Slovakia

PAYMENT SHOULD BE MADE AS:
•	Bank transfer payable to 
account number: 4008047362
account holder: ZDRUZ. POUZIVATELOV
IBAN: SK57 7500 0000 0040 0804 7362
SWIFT: CEKOSKBX
	Please make reference to "WMNC 2012 Registration" in bank documents along with paper number and name of registrant

CANCELLATION POLICY  
Registration fees for papers canceled after August 1st, 2012 are not refundable. All cancellations must be notified to the Conference Secretariat at wmnc@fiit.stuba.sk. Cancellations received prior to August 1st, 2012 will receive 50% refund of the fees. Cancellations received on or after August 1st, 2012 will not be refunded. 

DISCLAIMER OF LIABILITY
The conference organizers will not accept liability for personal injury or loss/damage to property/belongings of participants or accompanying persons, and occurring before, during or following the conference and its associated tours, or their stay in Slovakia. It is therefore recommended that participants and accompanying persons arrange for their own personal health, accident and travel insurance.

THE  REGISTRATION  FORM  MUST  BE  FILLED  and  TOGETHER  with  PAYMENT   TRANSFER  INFORMATION  emailed to   
wmnc@fiit.stuba.sk

		  					  Signature_______________________________________________________