###### SI2005 Registration 

Please fill in this application form and send it before July, 1 (Fri).
Any change of participation (schedule, meal etc.) should be sent to
        si05@muse.sc.niigata-u.ac.jp

Thank you in advance!

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### Information of Participant

 * Please try not to change/cancel your schedule you will put in this form.
 * Especially we like to ask you to refrain from changing your schedule
   just before the conference.
 * The possible longest period of the participation is 
   from Aug.11th night to Aug.18th noon.

 Attending : From August [    ]-th [ Breakfast / Lunch / Dinner ]
               to August [    ]-th [ Breakfast / Lunch / Dinner ]

 Name :                 [ Last Name ] ,[ (M.I.,) First Name ]
 Position or Title :    [         ]
 Sex :                  [ Female / Male ]
 E-mail:                [                      ]

### Affiliation 

 Affiliation :                  [                       ]
 Mailing Address :              [                       ]
 Postal Code :                  [                       ]
 Country or Citizenship :       [                       ]
 Phone Number :                 [                       ]
 Fax Number :                   [                       ]
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Short Talk

   * If you like to give short talk(s) please describe in below.
   * LaTeX format will be accepted.

  1. Title: [                                                         ]

  2. Abstract: (Please add also the related references, e.g e-print no. etc)

  [

   ]

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### Research activities or interests

 * Please write several lines note (in Latex), 
   which will be printed for introduciton among participants.

  1. Research activities or interests :

  [                                                                  

   ]

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### Financial Support

  1. Financial Support : [ not necessary / necessary ]

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### Accommodations

 * The longest stay is from Aug.10th night to Aug. 18th morning.
 * (Notice) Any changes or cancellation of room reservation is not allowed
   after July 8th (Fri).

  1. Reservation of a room :
     [ y/n ] Same as participation schedule (as above), or,
     [ y/n ] Input in following :
             from Aug. [   ]-th [ morning/noon/night ]
               to Aug. [   ]-th [ morning/noon/night ]

  2. type of room : [ Single(6200yen/night) / Twin(4200yen/night) ]
  3. If you have someone with whom you want to share the room, 
     fill his or her name in the following :
     [                                 ]

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### Meals

 * The longest period of meal is 
   from breakfast of Aug. 11th to lunch of Aug. 18th.
 * The price of meal : 
   breakfast(700 yen), lunch(900 yen), dinner(1,600yen)

  1. meal reservation :
     [ y/n ] Same as participation schedule (as above), or,
     [ y/n ] Input in below :
             from Aug. [   ]-th [ Breakfast / Lunch / Dinner ]
               to Aug. [   ]-th [ Breakfast / Lunch / Dinner ]
  2. Other request about meals (e.g. vegitarian food only, no poke, etc.):
     [                                                  ]

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### Accompanying person(s) (Guest(s))

 * For each accompanying person (except yourself), 
   please describe "name", "adult/child/infant", and "meal researvation".
 * Child( from 4 to 12 years old) : haml-price for accommodations, 
   600 yen for breakfast/lunch and 1,200 yen for supper.
 * Infant( from 0 to 3 years old) : 
   accommodations and meals will be provided without fee.
 * Name should be filled in the form of "Last name, (middle name,) First
   name". (to appear on name badge)


 Guest #1:      [ None // Adult / Child / Infant ]
  name #1:      [ Last, (Middle,) First name ]
  meal #1:
        [ y/n ] same as participant's, or,
        [ y/n ] input in the following:
                from Aug. [   ]-th [ Breakfast / Lunch / Dinner ]
                  to Aug. [   ]-th [ Breakfast / Lunch / Dinner ]

 Guest #2:      [ None // Adult / Child / Infant ]
  name #2:      [ Last, (Middle,) First name ]
  meal #2:
        [ y/n ] same as participant's, or,
        [ y/n ] input in the following:
                from Aug. [   ]-th [ Breakfast / Lunch / Dinner ]
                  to Aug. [   ]-th [ Breakfast / Lunch / Dinner ]

 Guest #3 .....

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### Other requests

If any, Please describe below :
 [

  ]

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