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REGISTRATION FORM
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      ILTS International Symposium on Low Temperature Science
                   30 November - 2 December 2015
     Institute of Low Temperature Science, Hokkaido University
                          Sapporo, Japan
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Family/last name: ...
Given/first name: ...
Title: (Prof./Dr./Mr./Mrs./Ms. etc.) ...

Affiliation: ...
Address: ...
City: ...
Postcode: ...
Country: ...

Telephone: ...
E-Mail: ...

I wish to give a presentation: (yes/no)
Title: ...
Preference oral/poster: ...

Dietary requests (vegetarian etc.): ...

Invitation letter required (for visa etc.): (yes/no)

Further comments: ...

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Please e-mail the completed form until 18 September 2015 to
              symposium[at]lowtem.hokudai.ac.jp
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