BUDAPEST 2004 Registration Form
On-line registration is available at www.conferences.hu/Budapest2004

Personal data
Please provide information as you wish it to appear on your Budapest 2004 attendee badge.

  Do not include my contact information in the Budapest 2004 List of Participants. 	

 Surname/Last Name	First Name	Middle Initial

 Job Title/Position

 Institution/Company

 Street Address

 City	State	Country

 Zip Code	E-mail

 Phone (Include country code)	Fax (Include country code)

Please indicate any special needs: 	

Please, register me for:
    	
IJCNN 2004  	                    		  FUZZ-IEEE 2004 		
I will present the paper No:			   I will present the paper No:		

Registration fees 

A. Conference  (All amounts are in Hungarian Forints (HUF) and include 20% VAT)

Registration	Member
IEEE. INNS, ENNS, JNNS	Non-member	Student *	Amount	
Early registration
(before 31 May  2004)	HUF 120000		HUF 150000		HUF 60000		HUF ……………....	
Late registration
(after 31 May 2004)	HUF 150000		HUF 200000		HUF 75000			
* A letter of verification from the head of department must accompany Student regsitration. Copies of student identification card are NOT acceptable. 

B. Printed Proceedings (All amounts are in Hungarian Forints (HUF) and include 4,76% VAT)

IJCNN 2004 	           HUF 30000/each (in  case of advance  order by 31 May 2004)	  	  	Number of volumes	……	HUF …...…….…	
FUZZ-IEEE 2004 	HUF 20000/each	(in  case of advance  order by 31 May 2004)	   	Number of volumes	…...	HUF …….…...…	
Printed proceedings subtotal	HUF ………....…	

Please note: Only a limited number of printed Proceedings will be available on-site for the price of  HUF 40.000/each

C. Tutorials on 25 July 2004 (All amounts are in Hungarian Forints (HUF) and include 20% VAT)

09.00 - 11.00	P. J. Werbos		R. Eckhorn 		N. Kasabov 		
11.15 - 13.15	D. Prokhorov		S. Draghici		K.Honda, F.Masulli & S.Rovetta		
14.30 - 16.30	B. Widrow		J. Weng		J. Mendel 		
16.45 - 18.45	E.  Micheli-Tzanakou 		Cs. Rekeczky & Á. Zarándy 		J. Kacprzyk		

Registration fees
per tutorial	Member
IEEE. INNS, ENNS, JNNS	Non-member	Student  *	No. of
tutorials	Amount	
Early registration
(before 31 May 2004)	HUF 26000		HUF 32000		HUF 13000		……….	HUF ……………	
Late registration
(after 31 May  2004)	HUF 32000		HUF 40000		HUF 16000		……….		
 * A letter of verification from the head of department must accompany Student regsitration.  Copies of student identification card are NOT acceptable. 

D. CNNA 2004 Registration (on 22-24 July 2004) (All amounts are in Hungarian Forints (HUF) and include 20% VAT)

Registration fee	Member
IEEE. INNS, ENNS, JNNS	Non-member	Student *	Amount	
Early registration (before 31 May  2004)		HUF	80000			HUF    95000		HUF 60000		HUF ……………....	
Late registration (after 31 May 2004)		HUF  100000			HUF  120000		HUF 75000			
* A letter of verification from the head of department must accompany Student regsitration. Copies of student identification card are NOT acceptable. 
E. Tours (All amounts are in Hungarian Forints (HUF) and include 20% VAT.)

•	For more information on the tours please visit www.conferences.hu/budapest2004/tours.htm

Date	Tour	No. of tickets	Cost/ticket	Cost/tour	
25 July 2004	Budapest Sightseeing Tour (half-day)	…………….	HUF   7500	HUF…………...….	
27 July 2004	Danube Bend / Dunakanyar (full-day)	…………….	HUF 20000	HUF……….…..….	
Tour(s) subtotal	HUF…………...….	

Total payment

A. Registration fee 	HUF  …………………………..	
B. Printed Proceedings subtotal	HUF  …………………………..	
C. Tutorial fee(s)  	HUF  …………………………..	
D. CNNA 2004 (22-24 July 2004) registration fee	HUF  …………………………..	
E. Tour ticket(s) subtotal	HUF  …………………………..	
Total amount to be paid 	HUF ………………………… 	

Payment information

Registrations will not be processed without payment.

1. Card:					  American Express      		   EuroCard/MasterCard       		  VISA

I agree to charge my credit card with the above total amount.

Card Number 	 Expiration Date 	

CVV Code 		
(Last 3 digits of the security code on the back side of the card or in case of AmEx card the security code /additional 4 digits on the front side)

Cardholder’s Name 	

Cardholder’s Signature 	

Billing Address 	

2. Bank transfer     

Payments by bank transfer should be sent to the following account of MTA SZTAKI:

Beneficiary:			MTA SZTAKI “Budapest 2004”
Account no.:			HU32 10032000-01738588-00000000 
Bank name:			National Bank of Hungary 
Bank address:		H-1850 Budapest, Hungary
SWIFT Code:			MANEHUHB

Please attach a proof of the remittance to this Registration Form and make sure that the name of each Conference participant is clearly indicated on all documents.

Please note:
- payments sent by bank transfer must be free of charges for MTA SZTAKI
- the cut-off date for early and late registrations will be strictly enforced.

Cancellation/refund policy

Requests for refunds of the registration fee (less 20% administration charge) will be honored only if they are received before 31 May  2004. No refunds will be given for cancellation requests received after that date or for non-attendance. 
Cancellation of tickets (tours) must be submitted in writing via post, fax or e-mail. Cancellations received before 31 May 2004 are subject to a 20% administrative fee. No refunds will be paid after that date.

Submit this form

by mail:	Budapest 2004 Local Secretariat, Mariann Kindl
			c/o MTA SZTAKI., Kende u. 13-17., H-1111 Budapest, Hungary	by fax: +361 386 9378	

Date ……………………………………………          Signature