================= Registration and Accommodation Form ==================

1) Name (title, first & family names) : _______________________________

2) Affiliation :_____________________________________________________
   
3) Postal Address : ___________________________________________________

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4) Email address : ____________________________________________________

5) Phone number : _____________________________________________________

6) Fax number : _______________________________________________________


7) Do you need financial support? (Yes / No) : _______________________
   (Please apply for financial support only if you have absolutely no support.)
   If "Yes", we need information about your home address and your job-rank.
 
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8) Accommodation request:
    check in date:
    check out date:
    special request:

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