First Name:

The additional cost for individuals who are not registered for the Conference is:

Cost Calculation

Conference registration $125.00
Extra Reception tickets Extra tickets 1 @ $20 2 @ $40 3 @ $60 4 @ $80 5 @ $100 6 @ $120 Extra Banquet tickets Extra tickets 1 @ $40 2 @ $80 3 @ $120 4 @ $160 5 @ $200 6 @ $240

Payment Options

Credit Card

1. If this option is selected, you will be transferred to the PayPal site when submitted
2. A credit card can be used through Paypal for a secure transaction.

Check payable to NEMA

Electronic Funds Transfer

If you have any questions, please contact:

Pam Larbig
(PLarbig@medicalimaging.org)

Howard Clark
(HClark@medicalimaging.org)

Nickname:

Last Name:

Job Title:

Company:

Address:

Address:

Email:

Since we must pay for any unfilled rooms in the DICOM block, we urge you to stay at the official Conference Hotel, the Crowne Plaza Chengdu. Are you planning to stay there?

Yes or No
If Yes, for how many nights?
_{We need this information so we can compare the hotel's guest list with our own registration data.} Reserve a hotel room

You will need a Visa to enter China and attend the Conference. A formal letter of invitation from our host, the University of Electronic Science and Technology of China, is needed to get that Visa. The first step is to complete the Personal Data Form and forward it to the persons listed at the bottom of the form. Every person in your party needs to do this.

If you will be accompanied by any family members or traveling companions, we need to know whether they wish to attend the reception on April 8 or the banquet on
April 9.