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The 1st Analog VLSI Workshop Preliminary Registration Form
(Please use a fixed width font like courier font to see this form.)

When you fill in the form, type in on top of the line. 
(The letters do not need to be fit in the given space.)   

Please send this form to hyogo@ee.noda.sut.ac.jp by April 18,1997,
if you attend the workshop.                         ^^^^^^^^^^^^^^
After April 18,1997, please contact Dr. hyogo: hyogo@ee.noda.sut.ac.jp .

Workshop Registratration:
Registration fee, which covers banquet, is $100. Although no registration fee is 
required for full-time students, $50 must be paid when they attend the banquet. 
Please pay the registration fee in cash (US dollar) at the workshop.
(Only on-site registration is available. )

Hotel Information:
We have reserved a block of rooms for the Workshop attendances at the hotel 
"Holiday Inn on the Lane" for  accommodation during the Workshop.
The hotel reservation form can be obtained by clicking "Hotel Reservation Form" 
on our web site http://ieej.si.noda.sut.ac.jp/~AVLSIWS/index.html (hotel location map, 
too) . Should you have some problem to get the form, please contact the Workshop 
secretariats. Please use this hotel reservation form and either mail or fax it directly 
to the Holiday inn on the Lane. It is vital that hotel reservations reach the Holiday inn 
on the Lane by April 11, 1997 to have the special Workshop rates.The rates will also be 
available on a limited basis for up to a few days before and following the Workshop. 
Arrival and Departure dates on the form can be changed on your schedule.

Workshop Web Site URL:
http://ieej.si.noda.sut.ac.jp/~AVLSIWS/index.html


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To: hyogo@ee.noda.sut.ac.jp
Cc:
Subject: 1st Analog VLSI Workshop Reg.
---------------

The 1st Analog VLSI Workshop Preliminary Registration Form
 
Title: Prof./Dr./Mr./Miss./Mrs./Ms.:
                                    ^^^^^
Name:
     ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
               Lastname / Firstname

Affiliation:
            ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
              Company, University, Government Agency

Address:
        ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
           Number street,                Mail stop   


        ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
           City,           State/Province,     Country


        ^^^^^^^^^^^^^^^^^^^^^^^^^
           Postal Code

Phone :
       ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
Fax   :
       ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
E-Mail:
       ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

(1) Classification:
                   ^^ 
    Please choose from A -> D to fill in the Classification: above.
     A: Workshop Attendance (General)
     B: Student (Speaker)
     C: Student (Attendance) 
     D: Attendance of only Banquet

    (1-1) If your answer is either B or C, also indicate 
          whether you will attend the Banquet.
          Please put an "x" on the right of Yes or No:

          Attend Banquet:Yes:   No:
                             ^^^   ^^^

(2) Banquet: 
    Please let us know your special Diet(Special Food, vegetarian, etc) 
    and we should be able to arrenge it for you. (please indicate below.)
      

    ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

(3) Optional Tour(s):
    If you would like to join the tour(s), put an "x" on the right of Yes, 
    if not, put an "x" on the right of No. 
     (The applications will be closed when all the places are filled, 
      so apply early.)
                     
        a) The Ohio State Univ. Tour (free):Yes:   No:   
                                                ^^^   ^^^
                                             
        b) Columbus Tour (may be free)     :Yes:   No:    
                                                ^^^   ^^^


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