IEEE BIOMS 2011 REGISTRATION FORM

2011 IEEE Workshop
on Biometric Measurements and Systems for Security and Medical Applications
Milan, Italy, 28 September 2011

_________________________________________________________________________________________________ 
Last Name					First Name				Initial

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Organization						 Street Address

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City			State/ Province 			Country			Postal Code

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Phone Number			Fax		 	E-mail Address 			IEEE Member Number

 	On or before
15 August 2011	After
15 August 2011	
IEEE Member	65 euro	80 euro	
IEEE Student / IEEE Life Member	35 euro	35 euro	

Registration Total _______ euro

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

One author registration will guarantee publication of up to two accepted papers.  
Payment will be honored by cash on site.

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.

SEND THIS FORM TO BIOMS2011 SECRETARIAT
E-Mail		bioms2011.dti@unimi.it
FAX		02-503-30010