Registration Form for HPR 2007

REGISTRATION FEE:
7000 yen "Haiku Pacific Rim Conference" before Feb. 10, 2007 and 9000 yen after Feb 10, 2007.


Early Registration ( 7000 yen) (meals and accomodation fee are not included)
Late Registration ( 9000 yen) (meals and accomodation fee are not included)

Mr/Ms	Mr. Ms.
First Name	*Required
Last Name	*Required
E-Mail	*Required
Address (street & town)
City
State/Province
Postal Code
Country
Question	(Please write with in 160 letters.)
Copy	Please check if you would like to receive the submitting content.
Confirm before Submission	Need confirmation No confirmation needed