Application Form for ICMART 98 Congress
MIYAZAKI
23-25 OCT. 1998

Please pay the "ICMART 98" Congress participation fee seperate from the YNSA Seminar. Take advantage of the price reduction !

(Early Registratiopn is until June 30. 1998)

Name.............................…………………………………….Title.....................…………
Adress................................................................................................................................ ...............................................................................................Country..............……….....
Tel...........................................................…..............Fax.............................................…..
Accompanying person, Name..........................................................…..…....................…

Are you intending to submit a paper..............................……................YES (…).…...NO (...)

Please send your abstract as soon as possible, in English, at least by June the 30. 1998
Your full written paper should be send in not later than August the 30. 1998, for the simultanious translaters.

Are you intending to give a Poster Session.....................…….....…… YES (…)…...NO (...)

Are you intending to exhibit ( books, instruments etc. ) ..…..........…......YES (...)........NO (...)

Date of arrival in Miyasaki........................Date of departure from Miyazaki.........................

(Let us know your Flt Nr. and arrival time in Miyazaki, when you know it.)

If you have not booked your Hotel through the Travel Agent, mark the Hotel of your choice below, it will be passed on to the NIPPON TRAVEL AGENCY. If your choice Hotel is fully booked, will you be satisfied with our choice .........….....….....……..........YES (...)…….NO (...)

KANKO HOTEL (...)   MERIDIAN (...)  AIRLINE HOTEL (...)  KENSINGTON (...) 

SUNLIGHT HOTEL (...)

These Hotels can be aid with VISA (...) or AMERICAN EXPRESS (...)

Please state your CREDIT CARD NR [..................................] Exp. Date [........................]

If you attend the YNSA SEMINAR, please note the question concerning Hotels in the SEMINAR
APPLICATION. Be prepared to pay these small places with cash. (Japanese Yen)
 
 
APPLICATIONS + INQUIRIES to
Yamamoto Hospital Management
1-10-15 Chuodori , Nichinan-Shi,
Miyazaki, Japan 887-0021
Tel: +987-223633 / 23 4815
Fax: + 987-235923


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