ICOQSIA 2022 : Registration Form
1. Salutation
2. Full Name
*
First Name
3. Email
*
example@example.com
4. Affiliation
*
5. Institutional Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
6. Country
*
7. Mobile Number
*
Please enter a valid mobile phone number.
8. Type of Registration
*
Please Select
Participant-Normal Rates
Participant-Early Bird
Student-Normal Rates
Student-Early Bird
Participant
9. Paper ID
*
10. Do you have any additional paper?
*
Please Select
Yes
No
11. No of additional paper
Please Select
1
2
3
12. Additional paper ID
use comma-separated if more than one
13. Are you using research's grant for the conference fee payment? (For UUM participants only)
Please Select
Yes
No
14. Total Payment
*
15. Method of Payment
*
15. Proof of Payment
*
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16. Proof of Student's Evidence (such as screenshot from student's portal)
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Submit
Should be Empty: