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RIdIM CONFERENCE 2011Salvador, Bahia Brazil, July 20-22, 2011

Registration Form

Please complete this form and return it as soon as possible but not later than June 30, 2011byemail to ridim2011@gmail.com. Confirmation of registration will be sent by email.

Early Registration fee is valid only to April 30, 2011 and can only be paid by bank transfer (detailssee bellow). After April 30, 2011, the Regular Registration Fee has to be paid. This fee can be paideither by bank transfer or at the Conference Registration Desk.

Participant(s)

Early Registration Fee

(valid to April 30, 2011)*

Regular Registration

Fee***US$ 100 Accepted Paper presenter US$ 130

US$ 75 Accompanying person(s)** US$ 100

US$ 75 Listener/Visitor US$ 100

US$ 200 Exhibitor US$ 270

US$ 150 Exhibitors additional representative(s)* US$ 200

* Early Registration Fee can only be paid by bank transfer (details see below).** Please indicate how many persons are being registered.*** Fee values in Brazilian Reais (R$) will be fixed according to exchange rates in July 2011. Students need to properly identify themselves to apply for 20% discounts.

Badge Information

MAGALHESCASTRO Surname(s)/Last name(s)*

BEATRIZ Given/First name(s)*

UniversidadedeBraslia Institution/Organization*

Professor Position

* Please enter the information as you want it to appear on your badge

Address of the Institution/OrganizationUniversidadedeBrasliaCampusUniversitrioDarcyRibeiro

Street & Number

Braslia City

70.910000 Postal/ZIP code

Brasil Country

556131071113 Telephone

Fax

beatriz@unb.br E-mail

I agree that my e-mail address is printed in the official participants' list (please check if yes)

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Exhibition Stand booking

Quantity Prices (US$)*

-- Exhibition stand 1,000

-- Internet access 40

* Values in Brazilian Reais (R$) will be fixed according to exchange rates in July 2011

Accompanying person(s) or Exhibitors additional representative(s)

-------------------------------------------------------------Surname(s)/Last name(s) 1st additional

person*

-------------------------------------------------------------Given/First name(s) 1st additional

person*

-------------------------------------------------------------Surname(s)/Last name(s) 2nd additional

person*

-------------------------------------------------------------Given/First name(s) 2nd additional

person*-------------------------------------------------------------

Surname(s)/Last name(s) 3rd additionalperson*

-------------------------------------------------------------Given/First name(s) 3rd additional

person*

-------------------------------------------------------------Surname(s)/Last name(s) 4th additional

person*

-------------------------------------------------------------Given/First name(s) 4th additional

person*

* Please enter the information as you want it to appear on the badge(s).

Evening program attendance (always at 20:00 h.)Please check the box(es) of the event(s) you like to attend.

Event # of persons

July 20: Opening Ceremony & Reception (included in registration fee) 1

July 21: Evening concert (included in registration fee) 1

-- July 22: Farewell dinner(not included in registration fee)* --

* Additional cost of US$ 35per capita to be added in your registration payment or its equivalent inBrazilian Reais (R$) at the Conference Registration Desk.

Post-Conference Tours booking

Please indicate your preference in numerical order and how many places you want to book.Prices per person (to be paid during the conference) will be defined before the Conference,depending on booking numbers, and will be announced on the Conference website.

Order Prices (US$)* # of tickets

----- Option 1 - A religious rendezvous (half-a-day) To be defined -----

----- Option 2 - A day over the Bay (1 whole day) To be defined -----

----- Option 3 - Visiting historical cities (2 days - 1 night) To be defined -----

* Values in Brazilian Reais (R$) will be fixed according to exchange rates in July 2011

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Registration fees (and selected options) amount

Please, list the price(s) and calculate the total amount of your registration (in US$).We appreciate your additional voluntary donation to the RIdIM Development Fund. Please add theamount you wish to donate.

Participant(s) fee(s) US$ 100

Exhibition Stand booking US$ --------------------Farewell Dinner US$ --------------------

Subtotal payment US$ --------------------

Donation to RIdIM Development Fund US$ --------------------

Total payment US$ 100

No registration is complete until full payment has been made.Checks can unfortunately notbe accepted. All bank costs are to be paid by the Conference

participant(s).

-- I will pay the aforementioned amount of US$ to the RIdIM bank account as indicatedbelow.*

I will pay the aforementioned amount of US$ at my arrival at the ConferenceRegistration Desk in the equal amount ofBrazilian Reais (R$)**

* If you have chosen an Early Registration (valid until April 30, 2011), payment needs to be doneby bank transfer (details see below)** Due to Brazilian Federal Law we are required to accept payments only in Brazilian currency.

For international payment use the RIdIM Bank Account information:

RIdIMBank: UBS AG, P.O. Box, CH-8098 ZurichAccount-No.: 251-8328 1843 NRouting number: 251IBAN: CH31 0025 1251 8328 1843 NSWITCH/BIC Code: UBSWCHZH80A

For payment from Brazil:Please contact us at ridim2011@gmail.com for local banking information.

Please indicate with your deposit your name and institution, and the detail RIdIM Conference2011.Please make sure that your deposit also covers any additional bank costs.