Registration Form(Not Use) This field is hidden when viewing the formRegistration CategorySpeakerAwardeeListenerExhibitionSponsorCo-SpeakerAccompanyThis field is hidden when viewing the formEvent CategoryConferenceAwardsMembershipEntry IDThis field is hidden when viewing the formRegistration typeKeynoteOralPosterWorkshopVideoTitleChooseMrMsMrsProfDrAssist Prof DrAssoc Prof DrProf DrName First Last Category*ChooseAcademiciansStudentBusinessThis field is hidden when viewing the formDesignationInstitution/organizationCountryEmail PhoneAbstract TitleThis field is hidden when viewing the formPostal AddressSelected ForThis field is hidden when viewing the formStatusUnder ReviewSelectedNot RecommendedRe-SubmitRegisteredNot RegisteredPost RegisteredProud to SelectedEvent Date & PlaceChoose24-26 April 2022 | London, United Kingdom(W)19-21 June 2022 | San Francisco, United States(W)21-23 August 2022 | Berlin, Germany(W)16-18 October 2022 | Paris, France(W)12-14 December 2022 | Dubai, United Arab Emirates(W)Type of Participation* Presenter (In-Person) - $899 Presenter (Virtual) - $499 Listener (In-Person) - $959 Listener (Virtual) - $559 Exhibiter (In-Person) - $1,999 Exhibiter (Virtual) - $999 No. of Participants12345No. of Accompanying Persons ( $200 Each )0123Accommodation Not Required Single Occupancy Double Occupancy Trible Occupancy Check In MM slash DD slash YYYY Check Out MM slash DD slash YYYY No. of Nights1234This field is hidden when viewing the formDescriptionPublishing and printing servicesCoupon Fee to be Paid 0.00 Publishing and printing servicesCurrency U.S. DollarPound SterlingEuroAustralian DollarBrazilian RealCanadian DollarCzech KorunaDanish KroneHong Kong DollarHungarian ForintIsraeli New SheqelJapanese YenMalaysian RinggitMexican PesoNorwegian KroneNew Zealand DollarPhilippine PesoPolish ZlotyRussian RubleSingapore DollarSouth African RandSwedish KronaSwiss FrancTaiwan New DollarThai BahtIndian Rupee Payment Method*PayPalBilling Address Street Address Address Line 2 City County / State / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Credit CardCard Details Cardholder Name