DS2000 Off-line Registration Form

This form should be used only if you don't prefer on-line registration.
Please print out this form, fill in the blanks, and send it to the following address by fax or air/surface mail.

Masahiko Sato, DS2000
Graduate School of Informatics, Kyoto University
Kyoto 606-8501, JAPAN
FAX: +81-75-753-4954

Personal Details

Please fill in the blanks below.
 

Family Name  
First Name  
Middle Name  
Affiliation  
Postal Address  
Zip Code  
Country  
E-Mail Address  
Phone  
Fax  

Registration Fee

Standard registration fee covers attendance in all sessions, a copy of the proceedings, refreshments, the reception party, and the banquet. Full-time student fee covers attendance in all sessions, a copy of the proceedings, refreshments, the reception party, but not the banquet.

Until Nov. 5, 2000:  Standard fee JPY25,000.-
Full-time student fee  JPY15,000.-
After Nov. 6, 2000: Standard fee JPY30,000.-
Full-time student fee JPY18,000.-

Please tick an appropriate box and fill in the number and the amount you will pay.
 
 

[    ]  Standard registration JPY_______________________(a)
[    ] Full-time student registration JPY_______________________(b)
[    ] Extra banquet tickets :
  JPY5,000.- per person x _________ person(s)		 JPY_______________________(c)
                     Total amount (a)+(b)+(c) JPY_______________________

Payment

Payment can be made by credit card (VISA or MasterCard) or bank transfer (recommended for domestic participants).  Please tick appropriate box and follow the instructions, respectively.

[      ]  Credit card :  For payment by credit card, please fill in the blanks below.

CREDIT CARD INFORMATION
Card Type (Tick either one)
 		  [     ]  VISA                     [     ]  MasterCard 
Card Number  
Expiration Date  
Name of Card-holder
(as it appears on the card)		  
Billing Address
 
  		 

[      ]  Bank transfer :

(i) Please transfer your payment in Japanese Yen to the following account.
Account name : Discovery Science 2000 Masahiko Sato
Account number : 3145447
Name of bank : Kyoto Bank, Gingakuji Branch
(ii) Send a copy of the receipt or the remittance invoice either by postal mail or by FAX to:
Masahiko Sato, DS2000
Graduate School of Informatics, Kyoto University
Kyoto 606-8501, JAPAN
FAX: +81-75-753-4954
Additional information or notes: (e.g. special dietary request)
 
 
 


If you have finished in filling all appropriate blanks,
please send all necessary forms by fax or air/surface mail.