<For Overseas Participants>

First International Workshop on New Group

 IV(Si-Ge-C)Semiconductors:

Control of Properties and Applications to Ultrahigh Speed and Opto-Electronic Devices

(SiGe(C) Workshop)

January 21(Sun.) 23(Tue.), 2001   Sendai, Miyagi, Japan

 

REGISTRATION FORM

 

 

Please complete this form and send it together with a copy of receipt for the bank transfer (if you pay the fee by a bank transfer) by FAX to

Junichi Murota, Laboratory for Electronic Intelligent Systems, Research Institute of Electrical Communication, Tohoku University

2-1-1 Katahira, Aoba-ku, Sendai 980-8577, Japan

Fax: +81-22-217-5548, Tel: +81-22-217-5548

e-mail: SiGe@murota.riec.tohoku.ac.jp

 

Please type or print in block letters.

Prof. Dr. Mr. Ms.
Name:                                                                                                                                           

(Family)                              (First)                                 (Middle initial)

Affiliation:                                                                                                                                         

Mailing Address ( Office Home):                                                                                                 

                                                                                                                                                     

(Zip code)                   (Country)

Phone:                               ext.                       Fax:                                

E-mail:                                                                           

Accompanying Person

Name:                                                                                                                                          

(Family)                                              (First)                                 (Middle initial)

Registration Fee

before Dec.15, 2000

after Dec.15, 2000

Banquet

Regular

¥15,000

¥20,000

¥5,000

Student

¥9,000

¥12,000

¥5,000

Accompanying Person


¥3,000

Grand Total ¥____________

Possibility Vegetarian Yes No

PAYMENT (Check either of the boxes): All payments should be made in Japanese yen.

Bank Transfer

Account Name: SiGe(C) WORKSHOP JUNICHI MUROTA

Accont No.: 315-1389727

Bank: Asahi Bank, Sendai Branch, 2-4-1 Ichibancho, Aoba-ku, Sendai 980-0811, Japan

I agree to pay Japanese                             yen by Credit Card: (for only attendees from overseas)

Card name: VISA MasterCard

Card number:                                                 , Expiration date:                                            

Cardholder's name(print):                                                                                       

Date:                                          Authorized Signature: