HOTEL AND TOUR REGISTRATION FORM for PKC'98, 5-6 Feb. 1998, Yokohama, Japan Hotel registration deadline: 9 January, 1998 (Friday) Title: [ ]Prof / [ ]Dr / [ ]Mr / [ ]Ms Sex: [ ]Male / [ ]Female Sur Name________________ Given Name________________ initial(s)______ Mailing address(for correspondence): [ ]Office / [ ]Home ____________________________________________________________________ ____________________________________________________________________ Country: _____________ Phone: ________________ Fax: _______________ Name(s) of Accompanying Person(s), if any: 1) _______________________________ 2) ______________________________ Arrival schedule: Airport___________ Date___________ Flight # ______ Hotel Accommodation Which Hotel: _______________________________________________________ Number of Signle rooms ________ Number of Twin rooms _________ Number of Nights: ____ Check in: __________ Check out: _____________ Amount of hotel deposit (10,000 Yen x # of rooms): (1) _________ Yen Accompanying Persons Program * AC-1 (Yokohama 1/2 Day Tour, 6,000 Yen/person) date: __________ # of persons: ____ Sub total (2) _________ Yen * AC-2 (Kamakura 1 Day Tour, 11,500 Yen/person) date: __________ # of persons: ____ Sub total (3) _________ Yen Grand total (1)+(2)+(3) _________ Yen Payment Methods (1) I(We) will pay the above grand total amount by credit card: [ ]Visa / [ ]MasterCard / [ ]American Express / [ ]Diners Club Card Number:_____________________ Expiration Date: ____________ Name of Card Holder:___________________________________________ or (2) I(We) have remitted the grand total amount on ___________ (Date) through my bank ______________________________ (Name of Bank) to Name of Bank: Bank of Tokyo Mitsubishi Ltd. Branch: Yokohama Address: 3-27-1, Hon-cho, Naka-ku, Yokohama 231, Japan Account Number: 0043079 (Ref. 126874-003) Account Name: Japan Travel Bureau, Inc. Date:_____________________ Signature:_____________________________ Please return the completed form (and a copy of the bank's receipt for remittance, if paid via Bank Transfer) to the following address: Japan Travel Bureau, Inc. Yokohama Convention Center (Ref. 126874-003) 4-75, Aioi-cho, Naka-ku, Yokohama 231, Japan Phone: +81 45 664 2760 Fax: +81 45 641 2059