APLAS 2009 / ASIAN 2009 Registration Form

Please fill out, print and fax this form to: +82 2 882 7234
ROSAEC Center, Seoul National University

Personal Information

Full Name:
Title:
Affiliation:
Address:
Email:
Phone (opt.):
Fax (opt.):

I don't want to be included on the attendee list.

Registration Fee

Conference:
(only for the choice of a proceeding)
Registration:
(1 proceeding, reception, banquet, 3 lunches)		 Late Regular (KRW 620,000) Late Student (KRW 500,000)
Student ID:
(for students only)
Extra Banquet Ticket: x KRW 100,000
Extra Proceeding (APLAS 09): x KRW 110,000
Extra Proceeding (ASIAN 09): x KRW 110,000
Total:KRW

Credit Card

Card:Visa Master
Card Number:---              (write by hand)
CVC:              (write by hand)
Expiration Date: /
Card Holder:
Signature:

Special Requirement

(dietery requirements, special care, etc)