Name:_____________________  _______________________  ________________________
           Surname                   First name          Middle name

Affiliation:_________________________________________________________________

Title: ( )Prof.  ( )Dr. ( )Mr. ( )Ms. ( )Other______________________

Mailing Address ( ) Office ( ) home

 ____________________________________________________________________________

 ____________________________________________________________________________

 ZIP ________________,  Country ______________________

 Phone ________________________  Fax _________________________

 email ________________________

Registration Fee (Full Registration) 13,000 yen/person

  Registration Fee __________________ yen       --- (A)


        - - -  Hotel Reservation Form (Tsukuba Daiichi Hotel) - - -

Room Type
( ) Single
( ) Twin

Check In Date   __________________

Check Out Date  __________________

Number of Rooms ______

Hotel Deposit (Twin: 19,000 yen/room, Single: 10,000 yen/room)

  Total Deposit  __________________ yen     --- (B)


Type of Payment (* Payment from inside Japan)
 (  ) Visa  ( ) Master  ( ) Bank Transfer*  ( ) Registered Mail*

 Credit Card Number _____________ _____________ _____________ _____________

 Expiration Date    _____________

Total Amount of Payment (A+B)   _______________________ yen

Name (print) ____________________________________________

Signature    _____________________________________________

Date         _______________________________


Registration Agency
           Mr. Akira Seo
           Tokyo Travel Service Co., Ltd.
           Toranomon Toyosumi Building, 3-22-11,
           Toranomon, Minato-ku, Tokyo 105, Japan
           Phone: +81-3-3459-6666
           Fax: +81-3-3434-0726