REGISTRATION FORM
(For authors and non-authors)
The Fourth International Conference on Machine Learning and Applications
December 15-17, 2005
Sheraton Gateway Hotel, Los Angeles, California, USA
http://www.cs.csubak.edu/~icmla/icmla05
Please complete your details below:
Paper ID/paper number (authors only): _________________
First Name:_________________ Last/Family Name:______________________
Title (Dr/Mr/Ms/Prof.):___________ Position:__________________________
Company/Univ.:_____________________________________ Dept.:____________
Address:______________________________________________________________
City:___________________ State:________________ Zip/Postal Code:______
Country:___________________________ Phone:____________________________
Fax:_______________________________ E-mail:___________________________
Mailing Address (if different from above):____________________________
______________________________________________________________________
Registration Fee (if received by October 1, 2005):
Non-student ($500): $__________
Full Time Student ($450): $__________
Method of payment (check/credit card) __________
Amount enclosed or Paid by a credit card (in U.S. Dollars): $__________
Payment reference number (if paid by a credit card) __________
Notes:
1. After October 1, 2005, registration will be accepted only if space is
available. A late fees of $50 is applicable after October 1, 2005.
2. All checks/money orders should be made payable to "ICMLA".
Payments must be in U.S. Dollars and cashable at any US bank.
If you wish to pay by a credit card please see instructions below.
3. To be eligible for student rate you must attach a letter from your
Department Head/Chair that states that you are a full
time student.
4. Registration Fee will include the following:
A copy of the conference proceedings;
conference dinner on December 16, 2005;
and coffee breaks.
Signature:_________________________ Date:________________
How to register:
Send the signed and completed registration form along with the
registration fee to:
Dr. Woogon Chung
ICMLA OFFICE
Department of Computer Science
California State University Bakersfield,
Stockdale Highway,
CA, 93311
U.S.A.
Email: wchung@cs.csubak.edu
Phone: 661 654 6757
Fax: 661 654 6960
(Tell No. for use by DHL, FedEx, UPS, ...: 661-664-3082)
To use a credit card:
If you wish to pay the registration fees by a credit card you should:
i) Send the completed and signed registration form to Dr. Chung (address given above).
You should include credit card payment reference number in the line 'Payment reference number'
which you can obtain from Mrs. Loraine Navarro (contact details given below).
ii) Mail/FAX/EMAIL the credit card authorization form to the following address:
Mrs. Loraine Navarro
Foundation Office
California State University Bakersfield
Stockdale Highway,
CA, 93311
U.S.A.
Email: lnavarro@csub.edu
Fax: 661 665 6915
Phone: 661 664 3163
Credit card authorization form for the ICMLA'05 Conference
The cardholders name:
The card number:
The Card type (we do not accept American Express or Diners Club):
The expiration date:
Amount to be charged to the card:
Account to be Credited: ICMLA Registration fees account
Signature of the cardholder (if mailed or faxed):