IEEE Conference Publication Hub Inquiry Form

Full Name:
Affiliation:
Address 1:
Address 2:
City:
State/Province:
Country:
Postal Code:
Email:
Phone:
Fax:
Role (Check all that apply): General Chair
Publication Chair
Finance Chair
Program Chair
Other
Signatory: Publication Agreement Signatory

* Full Conference Title: (Please include full formal name as it should appear on the publication.)

* Conference Acronym:  (Please do not include year or slashes with acronym)
* Conference Year:       
Conference Acronym and Year:

Location of the Conference:
* City: State/Province: * Country:

* Dates of the Conference:
Day: Month: Year: to Day: Month: Year:

* Please indicate the requested delivery date for the proceedings, and whether or not the delivery is made pre-conference or post-conference. Post-conference delivery will be by US Postal Service "Book Rate" to USA addresses on the conference-provided mailing list, and surface mail to addresses outside the USA, unless otherwise requested.
Day: Month: Year: Pre-conference Post-conference

* Who will be the primary conference contact for publications? (Please provide full name, affiliation, mailing address with telephone, fax, and e-mail information.)
Same as Inquirer
Full Name:
Affiliation:
Address 1:
Address 2:
City:
State/Province:
Country:
Postal Code:
Email:
Phone:
Fax:
Role (Check all that apply): General Chair
Publication Chair
Finance Chair
Program Chair
Other
Signatory: Publication Agreement Signatory

Optional Contact for publication:
Same as Inquirer
Full Name:
Affiliation:
Address 1:
Address 2:
City:
State/Province:
Country:
Postal Code:
Email:
Phone:
Fax:
Role: General Chair
Publication Chair
Finance Chair
Program Chair
Other
Publication Agreement Signatory

Finance Chair:
Full Name:
Affiliation:
Address 1:
Address 2:
City:
State/Province:
Country:
Postal Code:
Email:
Phone:
Fax:
Publication Agreement Signatory

Conference Web Homepage Address (URL):
http://