UT'98 CONFERENCE REGISTRATION FORM
Send this form to the Secretary of UT'98, Chang Kyu Rheem, Institute of Industrial 
Science, University of Tokyo, 7-22-1 Roppongi, Minato-ku, Tokyo 106, JAPAN
Fax: +81-3-3402-5349  Phone: +81-3-3479-0836   Email: rheem@iis.u-tokyo.ac.jp

Name:
  Title ____________ First _______________ Middle Initial _____ Last ______________
Affiliation:
            _______________________________________________________________________
Address:
 Street _________________________________________________ City ____________________

 State/Province __________________ Postal Code __________ Country _________________

 Telephone ___________________ Fax ___________________ Email ______________________

Guest Badge (Spouse Name) _________________________________________________________
Web Access to UT'98 web page: [  ] Yes  [  ] No

Member: [  ] IEEE  [  ] MTS  [  ] Other Participating Organization

Membership # _________________________

REGISTRATION FEES*1 in Japan Yen
                               [  ]On/Before March 6, 1998  [  ]After March 6, 1998
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 @ 5,000 yen/person*4              [  ] ____________________ yen

Extra Tickets for Reception 4,000 yen/person     [  ] ____________________ yen

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 transortation to/from the visit site and lunch.

METHOD OF PAYMENT ( All payments should be made in Japanese yen)
[  ] a) Bank Draft (Payable to UT'98)
[  ] b) Credit Card
  [  ]AMEX  [  ]Diners Club  [  ]Master Card  [  ]Visa Total Yen Due: _____________

  Name of Card Holder _____________________________________________________________

  Card Number _______________________ Date of Expiration __________________________

  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: UT98
  口座番号: 普通1327757
  振込(予定)日:      年    月    日