UT'00 CONFERENCE REGISTRATION FORM Send this form to the Secretary of UT'00
Name:__________________________________________________________________________________________
           Title         First                Middle Initial              Last 

Affiliation:___________________________________________________________________________________

Address:
   Street _______________________________________________City _________________________________

   State/Province ____________________ Postal Code ______________ Country _____________________

Telephone: ___________________ Fax: ____________________ Email: _______________________________

Guest Badge (Spouse Name): ____________________________________________________________________

IEEE/OES Member: [  ] Yes [  ] No, Other Membership: __________________________________________

REGISTRATION FEES in JPY*1
                                 On/Before April 15, 2000        After April 15, 2000
   Member*2                             [  ] 39,000 yen               [  ] 49,000 yen
   Non-Member                           [  ] 49,000 yen               [  ] 62,000 yen
   Student*3                            [  ] 10,000 yen               [  ] 10,000 yen

   Technical Tour*4                        5,000 x ___ = _____________________ yen
   (5,000 yen/person)
   Extra Tickets for Reception             4,000 x ___ = _____________________ yen
   (4,000 yen/person)
   Additional Copies of Proceedings       10,000 x ___ = _____________________ yen
   (10,000 yen/copy for Members)
   Additional Copies of Proceedings       15,000 x ___ = _____________________ yen
   (15,000 yen/copy for Non-Members)

             TOTAL  =                                   _____________________ yen
 
  *1 Registration Fee covers 1 copy of the Conference Proceedings, lunches, reception and coffee.
  *2 Member fees are applied to the persons who are the individual members of the sponsor 
       or participating organizations, the chairpersons and invited speakers.
  *3 Student Fee covers lunches and coffee.
  *4 Technical Tour Fee convers the transportation to/from the visit site and lunch.

METHOD OF PAYMENT ( All payments should be made in Japanese yen)

   [  ] a) Bank Draft (Payable to UT2000)

   [  ] b) Credit Card:  [  ]AMEX  [  ]Diners Club  [  ]Master Card  [  ]Visa

           Amount JPY: ____________________________ yen

           Name of Card Holder: _______________________________________________________

           Card Number: ___________________________ Fxp. Date: ________________________

           Signature: _________________________________________________________________

   [  ] c) (please ignore if you cannot read this) 銀行振込(日本国内のみ)

           振込先: 住友銀行 府中支店     口座名義: UT2000     口座番号: 普通 1466597

           振込(予定)日:__________年______月______日


Mail or Fax this form to : Chang-Kyu Rheem (Secretary of UT'00)
Institute of Industrial Science, University of Tokyo
7-22-1 Roppongi, Minato-ku, Tokyo 106-8558, JAPAN
Fax: +81-3-3402-5349  Phone: +81-3-3479-0836, E-mail:rheem@iis.u-tokyo.ac.jp