Speaker Registration - DALI  2002   

Please complete and return (FAX or email) to:  
Carl Vilbrandt -   vilb@u-aizu.ac.jp
                        FAX  +81-242-37-2772

Professional Title/Affiliation: 

Name: 

Name in kanji for Japanese attendees: 

Professional Address (including postal code): 

Professional Address in kanji for Japanese attendees (including postal code): 

Home Address in kanji for Japanese attendees (including postal code): 

Voice phone number: 

Fax number: 

Email address: 

WWW home page: 

Please indicate if a letter of invitation is needed (in addition to notification of acceptance by email):


(1) Hotel Accommodations at Aizu-Wakamatsu Hotel 

       FOR               (# of persons)

              Twin room/Single room      
     
              FROM: March                 (check-in date)     TO:                 (check-out date)                     nights (# of nights) 

(2) # of guests accompanying you to the workshop banquet  - Y5,000/each: 

(3) Audio-Visual Equipment needed for your presentation: 

           OHP 
           audio 
                 cassette tape player 
                 DAT 
           video 
                 NTSC tape 
                 live projection (from HTML, Powerpoint...) 

     Please specify any special requests.