Application Form for Attendance

1. Application Form for Attendance Please fill out the following form and return it by Fax or mail to: Japanese Society of Tribologists Kikai-Shinko Kaikan 407-2 3-5-8 Shiba-koen, Minato- ku, Tokyo 105-0011, Japan FAX: +81-3-3434-3556 The deadline for application: January 14 , 2005 th Application Fee: 35,000 yen (Regular Member of JAST or supporting organizations) *The ｆollowing are planned as supporting organizations. Society of Automotive Engineers of Japan/ The Japan Society of Mechanical Engineers The Japan Society for Precision Engineering/ The Japan Petroleum Institute 40,000 yen (Employee of Auxiliary Member Company) 50,000 yen (Non Member) 10,000 yen (Student Member) (Prof./ Dr./ Mr./ Ms.) Attendant: (Family) (Middle) (First) Section/Division: Affiliation: Address: ZIP+4/Postal code Phone / Fax: / @ E-mail address: Membership of [ ] Regular Member / [ ] Auxiliary Member / [ ] Student Member JAST: Member of other supporting organization: Please define [ ] □Visa □Master Card No. Remittance: \ [ ] Bank Transfer Exp. date Payment Cardholder signature Expected date of Remittance: [If you need extra registration forms, please copy this sheet or download from the TVT HP．] For further informationor any questions, please contact TVT home page or mail to: http://www.tribology.jp/others/TVT/TVT2005/ jast@tribology.jp Meeting site：EPOCHAL TSUKUBA/ http://www.epochal.or.jp.