REGISTRATION of ICQI03IIAS

REGISTRATION FORM (ICQI03IIAS)

Please send the Registration Form to the Conference Contact: Registration fee is 2,000 yen

NAME :

AFFILIATION :

POSITION :

ADDRESS :

Tel :

Fax :

E-mail :

DATE OF ARRIVAL : 27 of October, 2003 28 of October, 2003 29 of October, 2003 30 of October, 2003 31 of October, 2003 1 of November, 2003 2 of November, 2003 3 of November, 2003 4 of November, 2003 5 of November, 2003 6 of November, 2003 7 of November, 2003 8 of November, 2003

DATE OF DEPARTURE : 27 of October, 2003 28 of October, 2003 29 of October, 2003 30 of October, 2003 31 of October, 2003 1 of November, 2003 2 of November, 2003 3 of November, 2003 4 of November, 2003 5 of November, 2003 6 of November, 2003 7 of November, 2003 8 of November, 2003

Banquet Registration: From 7:00 pm, November 3 at

Hotel Metropolitan EDOMONT Iidabashi

PARTICIPATION (Around 5,000 yen), NON PARTICIPATION

ACCOMMODATION of ICQI03TUS

I do not need to stay the Hotel

I need to stay the Hotel Metropolitan EDOMONT Iidabashi

from 27 of October, 2003 28 of October, 2003 29 of October, 2003 30 of October, 2003 31 of October, 2003 1 of November, 2003 2 of November, 2003 3 of November, 2003 4 of November, 2003 5 of November, 2003 6 of November, 2003 7 of November, 2003 8 of November, 2003 to 27 of October, 2003 28 of October, 2003 29 of October, 2003 30 of October, 2003 31 of October, 2003 1 of November, 2003 2 of November, 2003 3 of November, 2003 4 of November, 2003 5 of November, 2003 6 of November, 2003 7 of November, 2003 8 of November, 2003

Number of accompanying persons

Send Reset

If you will send by e-mail, please send it to Conference Contact.

Banquet : From 7:00 pm, November 6

Date	4 of November	5 of November	6 of November	7 of November
Participation	[ ]	[ ]	[ ]	[ ]
Banquet			[ ]

ACCOMMODATION

HOTEL (approximate price, single room per a night):

Keihanna Plaza Hotel (about 10000 yen per a night)

Kodai 1-7, Seika-cho, Soraku-gun, Kyoto 619-0225, Japan

Tel : +81-(0)774-95-0101

Fax: +81-(0)774-95-0102

URL:http://hotel.keihannaplaza.co.jp/e/pages/index.htm

Date	4 of November	5 of November	6 of November	7 of November
Day	Tuesday	Wednesday	Thursday	Friday
Stay	[ ]	[ ]	[ ]	[ ]

Please send the above registration form to Conference Contact