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                         REGISTRATION FORM
                  Shape Modeling International '99
                           1-4 March, 1999 
                   Aizu-Wakamatsu, Fukushima, Japan

Please mail or fax this registration form to: 
SMI'99, Yamauchi Kazuaki
University of Aizu, Aizu-Wakamatsu, Fukushima, Japan 965-80.
E-mail: yamauchi@u-aizu.ac.jp  Fax: +81-242-37-2531
         
PLEASE TYPE OR PRINT CLEARLY

Surname:                        Given Name:               
Position/Title:                 Department:
Organization:
Address:
State:                  Post code:               Country:
Phone: (     )                     Fax: (    )               E-mail:


REGISTRATION FEE:               Before Feb. 15   After Feb. 15 

                  Society member   37,000 Yen .... 44,000 Yen   
                  Non-member ..... 41,000 Yen .... 49,000 Yen            
                  Student ........ 10,000 Yen .... 12,000 Yen

Society member means ACM, Eurographics or Computer Graphics society member.

METHOD OF PAYMENT (check one)
     
 |-----|  Bank (Telegraph) Transfer. Remittance should be directed to:
 |     |  Bank Name:  Fuji Bank Aizu Branch (712)
 |-----|  Address:    Aizu-Wakamatsu City, Fukushima, 965 Japan
          Acct. No. : 1557495
          Acct. Name: SMI99 Jimukyoku Yamauchi Kazuaki

 |-----| Credit Card. Check one: |-----| Master Card |-----| Visa |-----| Eurocard  
 |     |                         |     |             |     |      |     |  
 |-----|                         |-----|             |-----|      |-----| 

 Card #:                             Card Holder Name:
        ----------------------------                  ------------------------
 Expiration Date:                    Signature:    
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IMPORTANT. Credit card payment orders should **not** be sent by e-mail.

 |-----| On-site payment   
 |     |     
 |-----|  
On-site payment can be made in cash or by a credit card (Master Card, Visa, Eurocard).

ADDITIONAL PROCEEDINGS COPY ORDER
Any left over proceedings copies can be ordered at 5,000 Yen per copy.
I hereby order 
  |-----|                   |-----|  
  |     |                   |     |        
  |-----| copies. Charge me |-----| X 5,000 =                Yen.      
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Method of payment as specified above. The  copy (copies) will be sent
to your address after the conference is over and you will be charged only
if your order is granted.    

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