16h 17th DECEMBER 2010 THE GURNEY RESORT HOTEL AND RESIDENCES, PENANG MALAYSIA Organised by:

DEPARTMENT OF COMPUTER AND MATHEMATICAL SCIENCES , UNIVERSITI TEKNOLOGI MARA PULAU PINANG, MALAYSIA.

REGISTRATION FORM
Title (Datuk/Prof/Dr/Mr/Mrs/Ms): Name: Gender: Designation/Occupation: Address: Organisation:

Postcode: Country: Tel: Mobile:

City:

State:

Fax: Email:

Meals : Normal Title of Paper:

Vegetarian

Allergies: ____________________________

Preferable Presentation (Please tick ): Oral: Category (Please tick ): Engineering Biotechnology Science & Technology

Poster:

Tourism ICT/ Computing Education

Conference Secretariat International Conference on Science and: Applications in Industry and Education (ICSTIE 2010) Department of Computer and Mathematical Sciences Universiti Teknologi MARA Pulau Pinang 13500 Permatang Pauh, Pulau Pinang, Malaysia. E-mail: icstie2010@icstie.com Website: http://www.icstie.com Tel: +604-382 3566 Fax:+604-382 2766

16h 17th DECEMBER 2010 THE GURNEY RESORT HOTEL AND RESIDENCES, PENANG MALAYSIA Organised by:
DEPARTMENT OF COMPUTER AND MATHEMATICAL SCIENCES , UNIVERSITI TEKNOLOGI MARA PULAU PINANG, MALAYSIA.

I / we enclose cheque/ bank draft/ money order/ local order (No. ) of RM /USD

being payment for the following:

*Conference Fee (Please tick )

Early Birds (before 15 May 2010) Student (copies of Students ID are required) Presenters/Participants (after 15 May 2010) Poster presentation 2nd paper RM 250 USD 90 Local RM 550 RM450 RM 600 RM 500 Foreign USD 180 USD 160 USD 190 USD 170

*All price are EXCLUSIVE of accommodation (Inclusive of 1 set of conference materials, 4 tea-breaks, 2 lunches and 1 conference dinner, only). Date: __________________ Mode of Payment 1-Payment must be made in Malaysian Ringgit (MYR) for Malaysians only, and US Dollar (USD) for foreign participants. Bank Address: Manager, AFFIN BANK BERHAD, No.10 , Jln. Todak 1, Pusat Bandar Seberang Jaya, 13700 Seberang Prai, Penang, MALAYSIA Account Number : ABB 105 680 000 037 (TABUNG AMANAH UiTM PULAU PINANG) Swift Code: PHBMMYKL 2-All cheques must be made out to (Personal cheques are not accepted): BENDAHARI-UNIVERSITI TEKNOLOGI MARA, PULAU PINANG 3-Cash, bankers cheques, money order or bank drafts. Upon receiving the registration form and full payment, the Conference Secretariat will send a letter of confirmation. Last date for full-payment is 1th October, 2010 A 50% REFUND will be made for cancellations received in writing or by fax before 30th September, 2010. NO REFUND will be made if cancellation is received after this deadline (30th September, 2010).
Conference Secretariat International Conference on Science and: Applications in Industry and Education (ICSTIE 2010) Department of Computer and Mathematical Sciences Universiti Teknologi MARA Pulau Pinang 13500 Permatang Pauh, Pulau Pinang, Malaysia. E-mail: icstie2010@icstie.com Website: http://www.icstie.com Tel: +604-382 3566 Fax:+604-382 2766

Signature: ________________________________________