TWHM-ISA'98 REGISTRATION and ACCOMMODATION FORM

Family name: First name: Middle Initial:
Affiliation:
Address:
City: Post Code: Country:
Phone: Fax: E-mail:
Registration

(Including lunches during conference, reception on 8/30, Excursion and Dinner cruise on 9/1)

(by July 30 '98)
(After July 31 '98)

    [ ]¥30,000
    [ ]¥35,000

Acocomanying person

(Including lunch on 9/1, Excursion,Reception and Dinner cruise for non-participant partner)

    [ ]¥7,000

Accommodation

(by July 30, '98) (Including breakfasts during conference and dinner on 8/31)

participant (single room)
participant sharing twin room with another participant


participant sharing twin room with non participating partner

    [ ]¥40,000
    [ ]¥35,000 - per person
    (Please suggest name of another participant, if any):

    [ ]¥70,000 - total

Total

    ¥

Methods of payment:

[ ]Bank transfer to The Bank of Yokohama Ltd. Atsugi Branch Account no.:451-1742681, Account name:TWHM-ISA '98 Please send copy of the bank transfer receipt with this form.

[ ]Please charge my credit card Credit card number: