International Workshop on Challenge to Synthesizing Life Registration Form Given Name : Family Name : Telephone : E-mail Address : Affiliation : Postal Address : Title at Your Affiliation : Date of Attendance : 25 August (Tue.) Yes No 26 August (Wed.) Yes No Accommodations*: 24 August (Mon.) Yes No 25 August (Tue.) Yes No **Prices single : 16,500 JPY for one night (dinner and breakfast included) twin: 13,500 JPY for one night (dinner and breakfast included) Lunch**: 25 August (Tue.) Yes No *Price 1,200 JPY Special Requests to the Organizers (including accompany persons): Please send this registration form to imai@bio.phys.tohoku.ac.jp