金属矽化物及锗化物研究.doc

PAGE PAGE 2 REGISTRATION FORM Please print/type clearly and keep a photocopy of this form for your records. The information below will be reproduced in the participant list at the IIT 2004 and be used for all mailings. Please ensure the information you provide is correct. Please complete the form, and mail or fax immediately with the payment of your fee to IIT 2004 Secretariat. Also welcome to use the on-line registration at IIT 2004 web-site. On-line registration will be available on 12 April 2004. IIT 2004 SecretariatTze-Chiang Foundation of Science and Technology101 Kuang Fu Road Sec 2, Hsinchu 30043, TaiwanPhone: +886-3-5726360 Fax: +886-3-5716782E-mail: HYPERLINK mailto:IIT2004@tcfst.org.tw IIT2004@tcfst.org.tw Registrant Information: Abstract Code:__________________ (ex:B264) Type of Attendee: ?Author ?Participant ?Presenter Title: ? Prof. ? Dr. ? Mr. ? Ms. (please tick) Last Name: ________________________________________________________________ First Name: ________________________________________________________________ Organization: ________________________________________________________________ Address: ________________________________________________________________ Postal Code: ________________________________________________________________ Country: ________________________________________________________________ Tel: ________________________________________________________________ Fax: ________________________________________________________________ E-mail: ________________________________________________________________ Preferred Name on the Badge: ____________________________________________________ Accompanying Person/s: ? Prof. ? Dr. ? Mr. ? Ms Name: ____________________________ ? Prof. ? Dr. ? Mr. ? Ms Name:____________________________ Meal type: Special request for banquet/luncheon (tick one if required) Vegetarian □ Special Diet: ___________________ (please specify) Registration fee (per partic