SNP School 2012 Application Form											
						
Please delete inadequate/inappropriate items and 
send it to <snpsc12@lambda.phys.tohoku.ac.jp> 
with a subject title of "SNPschool2012 Application".
							
Title		Prof.     Dr.    Mr.     Ms. 	  
								
FAMILY NAME													
First Name									

Institute													
Email Address													
Telephone													
													
Nationality													
Do you need VISA to enter Japan?			Yes	No		
If yes :
Have you already contacted to the organizer?	 :	Yes      No

Supervisor (If you are student or postdoc, please attach a one-page recommendation letter of your supervisor)													
Supervisor's email address:													
Research Interest (about 100 words)				





Title and short abstract (< 1 page) of your presentation should be attached separately to this application form. 
													
Do you need to arrange hotel?	   Yes    No

If Yes:
Will you be accompanied by anyone?

Room Preference (we will try to honor your reservation preferences, but it is depended on the room availability) :
        Smoking,        Non-Smoking         
     Single Room,      Single Use of twin/double-Room, twin room, double room
										
11-Feb-2012	Sat 	Tokai :	Yes    No										
12-Feb-2012	Sun	Tokai : Yes    No		
13-Feb-2012	Mon	Tokai : Yes    No 			
14-Feb-2012	Tue	Tokai : Yes    No 							
15-Feb-2012	Wed	Sendai : Yes   No 				
 On the 15th, the organizer will arrange bus transportation from Tokai to Sendai with the inclusion a lunch.
		
16-Feb-2012	Thu	Sendai : Yes   No										
17-Feb-2012	Fri	Sakunami Hotspring : Yes  No 
 (The night session of the school will be held at the Sakunami hot spring on 17th.)
At the hot spring, you will enjoy a Japanese style dinner, the splendor of a natural hot spring, 
and accommodation sharing a room with other participants at Ryokan (Japanese traditional style hotel). 
To assign room, we need your gender :     Male      Female    	

18-Feb-2012	Sat	Sendai : Yes   No 					
			
There are a few restaurants and shops located within the nearby vicinity of the IQBRC (Tokai). 
We can arrange your lunch on 13th and 14th (included in the registration fee).
Do you need lunch at Tokai facility?        No    Yes for 13th & 14th respectively. 

Request for financial support : 												
											
													
													
Messages to Organizer (Special request etc.)