ELECTRO-CHEMICAL SIGNALING BY MEMBRANE PROTEIN: BIODIVERSITY AND PRINCIPLE March 14th, 15th, 16th/2007 Okazaki Conference Center, Aichi, Japan Registration Form Participation requires registration. For participants other than invited foreign scientists and invited Japanese speakers, please fill in this form and send to the following E-mail address: vsp@nips.ac.jp or fax number: (81) 564-59-5259. Registration fee is free. The deadline is February 10, 2007. (1) Your name: (first name) (last name) (2) Your affiliation: (3) Position (choose the following): ( ) Faculty ( ) Postdoc ( ( ) Undergraduate ( (4) Date of your participation: ) Technician ( ) Graduate student ) Others (describe if possible: March ( ) 14 ( ) 15 ) ( ) 16 (5) Whether you require lodging on campus or not. If you require, describe date of stay: ( ) I will stay at lodging on campus (date of stay: ( ) I do not stay ) (6) Your speciality field: (7) Whether you present a poster or just attend the meeting: ( ) Yes ( ) No ( ) Not decided yet (8) Whether you join banquet (on March 15) or not: ( ) Yes ( ) No Banquet fee is 4,000 yen for nonstudent, 3,000 yen for graduate student and undergraduate.