PDE 2004 : Registration form

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: