Call for papers | Registration | Program | Hotel & Travel | Postconference Activities | Contact us | Links | Supports |
Name in Roman letters Surname:___________________ Given Name ___________________ |
Name in Chinese character (if any): |
Mailing Address: |
E-mail address: |
Affiliation: |
[__] | A1 (including banquet) JP24,000Yen |
[__] | A2 (Not attending banquet) JP20,000Yen |
[__] | A1 student rate JP18,000Yen |
[__] | A2 student rate JP15,000Yen |
[__] | Credit card | [__] | Bank draft | [__] | Cash upon arrival |
[__] VISA | [__] MASTER CARD | ||||||||||||||||||
(1) Card Number | __ | __ | __ | __ | - | __ | __ | __ | __ | - | __ | __ | __ | __ | - | __ | __ | __ | __ |
(2) Expiry Date | ________ (month) / _________ (year) | ||||||||||||||||||
(3) Card Holder's Name | Surname: __________________ Given name: ___________________ | ||||||||||||||||||
(4) Amount of Payment | JPYen | ||||||||||||||||||
(5) Signature | |||||||||||||||||||
[__] IACL-11 Official Guest house | Please specify the date in case of later check in or earlier check out: Check in _____________ Check out _______________ |
Aichi Kosei Nenkin Kaikan | [__] Single [__] Twin The number of guests ________ (including _______ non-participants) Please specify the date in case of later check in or earlier check out: Check in _____________ Check out _______________ |
[__] MIELPARQUE NAGOYA | Please specify the date in case of later check in or earlier check out: Check in _____________ Check out _______________ |
Nagoya SUN PLAZA |
[__] Single [__] Twin [__] Suite [__] Tatami room for 3 persons [__] Tatami room for 6 persons The number of guests ________ (including _______ non-participants) Please specify the date in case of later check in or earlier check out: Check in _____________ Check out _______________ |
[__] will not stay at the conference official hotels. |
A. Sanage Spa & Nostalgic Asuke Kaido Tour [___] | |
B. Kyoto one-way trip | [___] Bus only |
[___] Bus & Hotel (Mitsui Garden Hotel Sijo) Please specify the room type: [__] Single or [___] Twin Check out ____________ |