Misasa2019 & Core-Mantle Coevolution registration form

Deadline for registration is extended till February 15.

This form will submit your registration information to LOC.
Please fill following fields, and then press Submit button at bottom.



At least, fill *-indicated fields.
Name *First name:
Middle name:
*Last name:
Affiliation *Affiliation:
E-mail address *E-mail address:
E-mail address *Confirmation:
Position
Address Street:
City/town:
State/province:
Country:
ZIP/Postal code:
Core Mantle
Coevolution
member?
Arriving date

*Select

Leaving date

*Select

Accommodation

Hotel accomodation is closed.
Please find hotel by yourself. If you need advices, we are happy to ansower.
Lunch box Lunch box (800 yen) is available during the meeting.
Check if you want to reserve them.




Banquet Do you like to attend the banquet?

We will invite you to the banquet to be held in 19th evening
at Blanc Art Misasa.
Registration fee for the banquet is 8,000 yen.
Presentation
preference
Check one:
Which session for
your presentation

title of
presentation
Requests or
questions
to LOC


If you have any troubles for the submission, please contact to here.