Registration Form

Please complete the registration form and send it to the ICMGP 2015 Secretariat
via email (info@mercury2015.com) or fax(+82-2-579-2662).

1. Participant Information
Title

Mr.

Name *

First

Ms.

Prof.

Ph.D.

Other (

Last

Department *

Position

Organization *
Country *
Phone Number*

ex. +82-2-123-4567

Mobile Number

ex. +82-2-123-4567

E-mail *
Abstract No.

Ex. 149996, 149997, 149998, 149999

* Please make sure to complete the payment of the abstract submission fee to be eligible for the review.
Special Request

Vegetarian

Other(

Accompanying Person
Title

Mr.

Name

First

Ms.

Prof.

Ph.D.

Other (

Last

Country

E-mail

Special Request

Vegetarian

Other(

* It is mandatory to complete Items marked with asterisks (*)

2. Registration Fee (A)

Category

Full Registration

Early Bird Registration

Regular Registration

(By April 15, 2015)

(After April 15, 2015)

Professional

USD 700

USD 900

Student 1

USD 550

USD 650

USD 200 x _____ day(s) = USD / Jun. 15 (Mon) Jun. 16(Tue) Jun. 18(Thu)

Daily Pass 2
Accompanying Person 3

Subtotal

USD 200 x _____ person(s) = USD

USD

* Full Registrants will be entitled to attend all Scientific Programs (Plenary Session, Special Session, Oral Presentation, Poster Presentation,
Conference Workshop), Social Programs (Opening Reception, Gala Dinner), Lunch, Coffee Break, Conference Bag(Proceedings, Program
Book) and Name Badge.

1. Students are requested to submit a valid student ID to verify their status with the Secretariat. Verification document can be submitted in file
format during the online registration, or by Email (info@mercury2015.com) or Fax(+82-2-579-2662).
2. Daily Pass : Available to select either June 15(Mon), 16(Tue) or 18(Thu). Multiple days can be selected. Except, Daily Pass DOES NOT
include any social programs (Opening Reception, Gala Dinner). If a Daily Pass registrant wishes to attend the Gala Dinner, a Gala Dinner
Ticket can be purchased separately in the Additional Request Section below.
3. Accompanying Persons are limited to spouse and/or children of fully registered participant and will be entitled to attend the Opening
Ceremony and Opening Reception, Poster Presentation and Exhibition, Gala Dinner.

3. Social Events (B) Optional

Category

Date

Unit Cost

No. of Person

Total

Gala Dinner

June 18(Thu)/

USD 100

USD

( Daily Pass & Accompanying Person Only)

18:30~20:30

Glitz & Glam Quicksilver Night

June 16(Tue)/

USD 30

USD

18:30~20:30

Subtotal

USD

4. Bank Information
Total Amount(A+B): USD
Bank Transfer
- Bank Name: HANA BANK
- Account Number: 166-910001-38138
- Swift Code: HNBNKRSE
- Account Holder: KOSEHT)
- Bank Address: 46, OPAESAN-RO, SEONGBUK-GU, SEOUL, KOREA
* Copy enclosed: Payment Date:

Name of Remitter:

< Notices >

Wire transfers should be followed by a copy of bank remittance.

All bank charges for remittance must be borne by the registrant. In the case of short payments,
you will be required to pay the balance at the on-site registration desk.

Please note that the fee must be transferred under the registrant's name and must be stated on the receipt.

5. Cancellation Policy
Cancellation must be notified to the Secretariat by e-mail (info@mercury2015.com) or fax(+82-2-579-2662).
All refunds will be made after the Conference for administrative reasons.
All bank services charges and administrative fees will be deducted from the refund amount.
Please refer to the following date for cancellation.

on April 30

May 1 ~ 15, 2015

From May 16, 2015

10% of registration fee will be deducted

20% of registration fee will be deducted from

Registration fee will not be refunded.

from the refund.

the refund.

Date:

Signature: ___________________________________