ICEST 2016 Registration Form

ICEST2016 Registration Form 8th International Conference on Environmental Science and Technology (ICEST2016) June 6-10, 2016, Hilton Hotel, 12400 Greenspoint Dr., Houston, Texas 77060, USA (If you register online at http//www.AASci.org/conference/env/2016/registration.html, please DO NOT fill in this form) PLEASE PRINT Last Name (Family Name) First Name (Given Name) M.I. Title/Position, Ms. Mr. or Dr. Department Institution Address (Street Number and Name, Mailing Address) City State/Province Postal/Zip Code Country E-mail Phone Fax (Please check an appropriate box below) By 10 March, 2016 By 1 May, 2016 After 1 May, 2016 On-site (6-10 June, 2016) Standard ? US$720 ? US$795 ? US$865 ? US$890 Full-time Student ? US$430 ? US$450 ? US$470 ? US$490 All presenters and session chairs are expected to register before the conference with standard fees. A copy of current student ID is required to receive the student fee. To confirm your registration, payment is required (Please check one or more appropriate boxes below): ? Wire Transfer (Please contact us before transferring funds) ? Money Order; ? Check (accept US checks only, payable to the American Academy of Sciences and reference the Environmental Conference). ? Visa ? MasterCard Credit Card Number Expiration Date (mm/yyyy) / 3-digit Card-Verification-Code (CVC) on the back of your credit card Card Holder Signature of Cardholder Paid U.S. $ The registration fee is available for refund only if the cancellation is received by May 5, 2016. No exceptions apply, but all paid registrants will still receive the materials covered by the registration fee regardless of attendance. Substitutions are accepted however; advance notice would be greatly appreciated. If AAS cancels the event due to circumstances beyond AAS’s reasonable control including but not limited to acts of God, government emergency, labor strikes, acts of war, and/or unavailability of the event facility, AAS will refund to attendee his/her paid registration fee minus a portion of the event costs acquired by AAS. This refund will be the attendees’ exclusive remedy and AAS’ only liability for cancellation of the event for reasons described above. Registration Methods: ? Online Via Web: http://www.AASci.org/conference/env/2016/ registration.html ? Fax: 713-776-9767 ? E-mail: registration@AASci.org ? Mail: Environmental Conference American Academy of Sciences 9720 Town Park Dr. Ste 18 Houston TX 77036, USA Abstract or other Ref.# (if any): Comments: FOR OFFICE USE ONLY DATE FEE $ REG # REC # OFFI #