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<head><title>ITC-8 Online Registration</title></head>

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<h2>Registration Online</h2>
Please fill out and return this form by <strong>August 25, 1997</strong> to the conference secretary.<br>
After filling it out, press <b><em>"Send this form"</em></b> button
at the bottom of this page.
<hr>


<form method=POST action="http://www.LHD.nifs.ac.jp/cgi-bin/form-mail-itc8-reg.pl">

<b>SurName:</b> <input name="SurName" size="25"><br>
<b>FirstName:</b> <input name="FirstName" size="25"><br>
<b>Professional Title(s):</b> <input name="ProfessionalTitle" size="35"><br>
<b>Affiliation:</b>
<pre>	<textarea name="Affiliation" rows=3 cols=40> </textarea></pre>

<b>Address:</b>
<pre>	<textarea name="Address" rows=3 cols=40> </textarea></pre>
<b>Country:</b> <input name="Country" size="25"><br>
<b>Phone:&nbsp; &nbsp;</b> <input name="Phone" size="35"><br>
<b>Fax:&nbsp; &nbsp; &nbsp; &nbsp;</b> <input name="Fax" size="35"><br>
<b>E-mail:&nbsp;</b> <input name="Email" size="35"><br>
<b>Information can be transmitted to the above address until (date):</b> <input name="AddressExpireDate" size="15"><br>
<b>After that, information should be sent to (address):</b>
<pre>	<textarea name="NewAddress" rows=3 cols=40> </textarea></pre>
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<b>Title of Paper to be presented:</b>
<pre>	<textarea name="Title" rows=3 cols=40></textarea></pre>

<b>Accompanying Person(s):</b> <input name="Accompany" size="35"><br>
<b>Special Requests:</b> <input name="Request" size="35">
<p>


<hr>

<INPUT TYPE="submit" VALUE="Send this form">
<INPUT TYPE="reset" VALUE="Erase whole columns">
</form>

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<address>itc8@nifs.ac.jp</address>
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