Application Form：Culture and Computing 2011

International Conference on Culture and Computing
20-22 October, 2011 in Kyoto University, Japan

A form must be completed for each registrant. The deadline of late registration is September 30th October 10th.

How to Apply and Register;

1. Please complete an application form
2. You will receive a registration form by e-mail soon.
3. Please complete the registration form; must include credit card information; a credit card number along with signature of approval, and fax it to +81-75-753-3350 by the due date.

Application Form

Please fill out all fields below.

Title:	( Prof. Dr. Mr. Ms.)    (Please check appropriate one)
Last Name:
First Name:
Nationality:
Affiliation:
Phone:
Fax:
E-mail:

Registration fee(Please check appropriate one)

Early, Regular (by September 10th) JPY24,000.-	Early, Student (by September 10th) JPY12,000.-
Late, Regular (by October 10th) JPY27,000.-	Late, Student (by October 10th) JPY15,000.-

Banquet(on October 21st, @ JPY3,000.-/ person)

Note:The number of registrations for the banquet is fixed due to space limitation. Reservations are accepted in order of registration.

Attend

Total number of participant(s): 1 2 3 4 5 person(s) Accompanying person’s name: Please check the box if you would like vegetarian food (no meat, fish and eggs).

Not Attend

Memo (request about address of registration fee receipt):

We can accept payment ONLY through credit card (Visa or MasterCard). Payment will be made in Japanese Yen. Please note that the registration fee is NOT REFUNDABLE.