WORKSHOP REGISTRATION FORM
          for PKC'98, 5-6 Feb. 1998, Yokohama, Japan

Workshop registration deadline:   9 January, 1998 (Friday)

Title:     [ ] Prof / [ ] Dr / [ ] Mr / [ ] Ms

Last Name:   _______________________________________________________

First Name:  ___________________________ Sex: [ ] Female / [ ] Male

Affiliation: _______________________________________________________

Mailing Address: ___________________________________________________

____________________________________________________________________

____________________________________________________________________

Phone:  __________________________ Fax: ____________________________

E-Mail: ____________________________________________________________

Contributor of a paper:                          [ ]Yes / [ ]No

Number of accompanying persons who will be
attending the banquet on 5 Feb. 1998             _________ person(s) 

Workshop Registration Fee:                       13,000  Yen

Method of Payments:
  Workshop registration fees must paid be in Japanese Yen
  to the following PKC'98 bank account via Bank Transfer:

      Bank Name:      Dai-ichi Kangyo Bank
      Branch:         Roppongi
      Address:        7-15-7 Roppongi, Minato-ku, Tokyo 106, Japan 
      Account Number: 053 1997301
      Account Name:   PKC98

Date: _____________________ Signature: _____________________________

Post/Fax                          |
 (1) the completed form, and      |
 (2) a copy of remittance receipt |
to:                               |For More Information:
                                  |
  PKC'98 Co-Chairs                | Phone: +81 3 3402 6231 ext. 2327
  Imai-Lab, the Third Department  | Fax:   +81 3 3402 7365
  Institute of Industrial Science | E-mail:
  The University of Tokyo        /   pkc98@imailab.iis.u-tokyo.ac.jp
  7-22-1 Roppongi, Minato-ku    / URL:
  Tokyo 106, JAPAN             /   http://hideki.iis.u-tokyo.ac.jp/