PDE2004 Resistration page

Title : Dr. Mr. Ms.
Name :
Institute/University :
Address :
Tel :
Fax :
E-mail :
Do you want to researve the following hotels?
( Please see the accomodation in the top page ) :Yes No
If yes, please give us the followings:

    Washinton Hotel, Prince Hotel

    Smoking room, No-smoking room

    Twin room, Single room

    Check-in Check-out
Are you a vegitarian? : Yes No
Will you attend the banquet at July 21? : yes no
Number of accompanied person for the banquet :
Other requests or comment: