International Workshop gFrom Soft Matter to Protocellh
Registration Form

Last Name :
Family Name :
Telephone : 
Fax :
E-mail Address :
Affiliation : 
Postal Address :
Title at Your Affiliation : 
Date of Attendance :
        18 September (Wed.)	Yes	No
	19 September (Thur.)	Yes	No
	20 September (Fri.)	Yes	No
Title of Your Talk 1:

Attendance to Banquet2 and Excursion3 :
	Banquet		19 September (Thur.)			Yes	No
	Excursion 	20-21 September (Fri. - Sat.)		Yes	No
If you have a plan to visit other places in addition to Sendai, please specify your plan and  host4:


Special Requests to the Organizers (including accompany persons):


1 Your abstract should be submitted by Aug. 31 following instruction of Abstract section.
2 Workshop banquet will be held in the evening of September 19. It will cost 5000 JPY/person
3 We are planning a 2 days excursion to Matsushima and stay at a Japanese style Hotel with hot spa. The cost will be 20,000 JPY/person. For details please visit Excursion section.
4 This information is very important for the support of your travel expense.