ICONISCSE 2018 Presenter Registration Form
Email address *
Salutation *
Name *
Paper ID *
Paper Title *
Affiliation *
Address *
Phone Number *
Email *
Name in Certificate *
Additional certificate can be requested on-site (IDR 100.000/certificate)
Upload the scanned payment slip / proof of payment with credit card / proof of bank transfer (pdf, jpg, jpeg, png - max 1 MB) *
Required
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