The International Applied Statistics Conference 2011

Applied Statistics Association of Sri Lanka (ASASL)
No. 275/75 , Prof. Stanley Wijesundera Mawatha,Colombo 07, Sri Lanka.

REGISTRATION FORM

Deadlines of Receipt at ASASL, Sri Lanka

    Early bird registration deadline for SAARC and International participant is extended to 30th September 2011
 
SECTION A - PERSONAL DETAILS
Title :
Family Name (Last Name):
First Name (Given Name):
Middle Initial(s):
Gender:
Badge Name (Specify how you would like your name to appear on Name Card):
Institute/University/Organization:
Street Address:

City:     State/Province:

Zip/Postal Code:     Country:    

 Email:     Telephone: +    Fax: +

Meal Requirements :

 
SECTION B - TYPE OF REGISTRATION
Category

International / Speaker Participant (Full conference)
International Full-Time Student (Full conference)
SAARC Participant (Full conference)
SAARC Full-Time Student (Full conference)

 

THOSE WHO ARE PRESENTING A PAPER PLEASE COMPLETE ALL SECTION

THOSE ARE NOT PRESENTING A PAPER PLEASE SKIP SECTION C

 
SECTION C - PRESENTATION
Title of Paper :
Authors' Names, Affiliations and E-mail Addresses: (Please tick the presenting author)
Author's Name
Affiliations
Email Address

Presenting Author
1
2
3
4
5
Note that there will be one multimedia projector available with a laptop in all presentation rooms. If you need any additional equipment for your presentation, please list here. We will try to accommodate such requists.
Audio Visual Requirements:
 
SECTION D- PRE-CONFERENCE REGISTRATION
Pre-Conference Workshhops:

Workshop 1 (Half day) - 26/12/2011    (or/and)     Workshop 2 (Full day) - 27/12/2011

 
SECTION E: CONFERENCE DINNER PARTICIPATION
Registration fee of the International/SAARC participants includes the cost of dinner.
 
Details of the accompanying persons for dinner (LKR 4,000/= (~US$ 37) per person).
Title
Family Name
First Name
Dinner Type
1
2
3
4
5