CONFERENCE AUTHOR REGISTRATION FORM

Proceedings Included

The Third IASTED International Conference on Telehealth and Assistive Technology

Please print this form, fill in the required information, and return it together with proof of payment to:
IASTED Secretariat TAT 2016
Building B6, Suite #101, 2509 Dieppe Ave S.W
Calgary, Alberta, Canada T3E 7J9
Tel: +1 403 2881195, Fax: +1 403 247-6851
E-mail: calgary@iasted.org Web Site: http://www.iasted.org
Paper Number: ____________
Registration materials must be received by August 20, 2016

Last Name (Family name) ______________________________ First Name __________________________________

Title: Prof Dr Mr Mrs Miss Ms Position _________________________________________________________
Department ________________________________________________________________________________________________
University/Company ________________________________________________________________________________
Address _____________________________________________________________________________________
City_________________________________________ Province/State _______________________________________
Country ______________________________________ Postal/Zip Code_______________________________________
Tel ______________________________________ Fax _______________________________________________
E-mail __________________________________________________________________________________________

Please note: IF paying by bank transfer, please use Euro amount, if paying by credit card or cheque please use USD amount.
IASTED Non- Student**
Paper Number _____________ No. of Pages _____ Member Member Author Amount

Registration Fee* 590/$650 655/$720 590/$650 _____________

Membership # (required for membership rate) ____________
Extra pages ________ pages @ 45 / $50 per page (Due for papers over 8 pages) _____________

Late Registration Fee*** IASTED Non- Student**

Member Member Author Amount

635/$700 700/$770 635/$700 _____________

Additional paper(s)**** (Additional paper(s) of up to 8 pages: 360 / $400 EACH
Additional Paper Number _____________ No. of Pages _____ _____________
Additional Paper Number _____________ No. of Pages _____ _____________
Extra pages ________ pages @ 45 / $50 per page (Due for papers over 8 pages) _____________

Additional lunch Tickets ________ @ 90 / $100 each _____________

(Note: Registration fee includes one lunch ticket)

IASTED Membership (1 year) 110 / $120 per person (Postage and handling not included) _____________
Membership includes reduced conference fees and a complimentary journal.
Please place an X beside your journal choice below:
____ Control and Intelligent Systems
____ International Journal of Power and Energy Systems
____ International Journal of Robotics and Automation

Postage and handling Fee:

Shipping Charges for 201 and 203 (Canada and U.S) @ US $35 each _____________
Shipping Charges for 201 and 203 (International) @ US $55 each _____________
Shipping Charges for 206 (Canada and U.S) @ US $55 each _____________
Shipping Charges for 206 (International) @ US $80 each _____________

TOTAL EUROS / USD _____________

* REGISTRATION includes: online proceedings, all conference sessions, tutorials, keynotes, plenaries, cybathlon, and refreshments
during the conference, and the lunch. Please note that in the event you choose to withdraw, a non-refundable handling charge of
145.00 / US$160.00 will be deducted prior to issuing the refund. Refunds will only be issued until the registration deadline of
August 20, 2016.

** STUDENT AUTHOR REGISTRATION FEE: A copy of the student I.D. is required to register with the student rate.

*** For late registration please contact us.

**** ADDITIONAL PAPERS: An author with more than one paper pays the additional paper(s) rates shown on the previous page,
unless a co-author has also registered and paid the full registration fee.

Select method of payment:

______________________________________________________________________________________________________

__ Payment by cheque, made payable to IASTED. Cheques must be in US dollars drawn on US banks, or must be an International Money
Order/Bank Draft in US funds. Please fax a copy of the cheque with your registration form, and mail cheques to:
IASTED TAT 2016
Building B6, Suite #101, 2509 Dieppe Ave S.W
Calgary, Alberta, CANADA T3E 7J9
_________________________________________________________________________________________________________________

__ Payment by VISA or MasterCard (US dollars only): VISA or MasterCard # _________________________________________

Expiry date ___________________ Cardholder's Name______________________________________________

Date _________________________ Cardholder's signature __________________________________________

_________________________________________________________________________________________________________________

__ Payment by bank transfer (in EUROS only), You MUST include the following information on your
made payable to IASTED:
bank transfer documents in order for your payments to be
Name of Account: WMSF
processed:
Account #: 251-813899.61 M - Name
UBS - Paper Number
Theaterstr. 20, 8024 Zurich, Switzerland - Conference (i.e. TAT 2016)
Swift Transfer Code: UBSWCHZH80H
IBAN: CH03 00 25 1251 8138 9961 M

NOTE: You must FAX OR EMAIL A COPY OF THE BANK TRANSFER to +1 403-247-6851 or Calgary@iasted.org as proof of payment. A
registration will not be considered complete without this proof.

Please note the following:

In order for a paper to be published, the following requirements must be met:

(1) The paper must be registered and fully paid for.

(2) The paper must be presented by one of the authors at the conference.

(3) Using the username and password that you used for your initial paper submission, submit your final paper online in PDF format at
http://pdfportal.iasted.org Please ensure that your paper is correctly formatted before submitting.

(4) Deadline for registration and full payment is August 20, 2016. Deadline for final paper submission is August 20, 2016. Failure to meet either of
these deadlines will result in your paper NOT being published.

(5) Complete the Copyright form on page 3 and fax it to IASTED at 1-403-247-6851

****You must attend the conference in order to receive the Proceedings.

I hereby acknowledge that I have read and understood the above agreement, and will conduct myself accordingly.

Date _________________________ Signature ___________________________________________________

 International Association of Science and Technology for Development
COPYRIGHT FORM

SUBMIT BY FAX OR EMAIL TO:

IASTED Secretariat: +1 (403) 247-6851 or Calgary@iasted.org

All IASTED Journals and Proceedings are published through ACTA PRESS, and as such this Form assigns copyright to IASTED
and ACTA PRESS. An Author of a co-authored Paper may sign on behalf of all co-authors. That Authors Signature then
becomes a warranty to IASTED and ACTA PRESS that they are authorized to do so.

Author(s): ___________________________________________________________________________________________

Paper Title: __________________________________________________________________________________________

Paper Number: _____________________________

1. The Author(s) transfer copyright in the Paper, transferring to IASTED and ACTA PRESS the exclusive right to publish,
distribute, reproduce or sell the Paper by printed, electronic or other means. The Author(s) retain all other proprietary rights
explored by the Paper arising from Patent, process or other such proprietary intellectual property.
2. The Authors warrant the Paper is unpublished, original and does not infringe upon the copyright of others. Where the Paper
contains previously published content or content otherwise subject to copyright, the Author(s) warrant to have obtained all
necessary permissions.
3. The Authors agree the Paper cannot be re-published, distributed or sold in whole or part other than by IASTED and ACTA
PRESS without the prior written permission of IASTED and ACTA PRESS.
4. By signing below the Author(s) warrant they are authorized to transfer exclusive copyright in the Paper to IASTED and ACTA
PRESS. Where the Paper is co-authored and less than all Authors sign below, the signatory(ies) warrant to have authorization to
sign on behalf of and bind all Authors of the Paper. The Author(s) indemnify and hold IASTED and ACTA PRESS harmless
from any and all damages that may arise from the Author(s) breach of any of the within warranties.
5. U.S. Government Employee Certification (if applicable): I certify that the Author(s) of this Paper are employees of the U.S.
government and prepared the Paper within the scope of their employment. As such, the U.S. government has permission to
reproduce all or part of the Paper, and to permit others to do so, for official U.S. Government purposes.
* Initial if section 5 is applicable: ________
6. Crown Copyright Certification (if applicable): I certify that the Author(s) of this Paper are employees of the British or British
Commonwealth Government and prepared this Paper within the scope of their employment. As such, the Paper is subject to
Crown Copyright and is not assigned to IASTED or ACTA PRESS. The Author(s) acknowledge that IASTED and ACTA
PRESS have the right to publish, distribute, reproduce or sell the Paper by printed, electronic or other means.
* Initial if section 6 is applicable: ________

Signature of Author(s) Date

(1)__________________________________________ _____________________________

(2)__________________________________________ _____________________________

(3)__________________________________________ _____________________________

(4)__________________________________________ _____________________________

IASTED Secretariat, B6, Suite 101, 2509 Dieppe Ave. SW, Calgary, AB, Canada T3E 7J9
Telephone: +1 (403) 288-1195, Fax: +1 (403) 247-6851