IEEE EESMS 2010 REGISTRATION FORM

2010 IEEE Workshop on Environmental, Energy, and Structural Monitoring Systems
Taranto, Italy, 9 September 2010

_________________________________________________________________________________________________ 
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 2010	After
15 August 2010	
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 EESMS2010 SECRETARIAT
E-Mail		eesms2010.dti@unimi.it
FAX		02-503-30010