Title: (Mr. Mrs. Dr. Ms)              First name:                                                   Last name:

Institution:

Department                                                                     Email: 

Mailing address:

City:                                                           State:                                 Postal/ Zip code:       

Country:                                                   Telephone:                                       Fax:

Broad Field of Research: (e.g. Banking, Management, etc.)

Are you willing to work as a reviewer                 Yes                           No

Will the co-author join the conference                Yes      N0. If yes, provide his address and affiliation