7th International Conference on Practical Linguistics of Japanese (ICPLJ7)
March 5-6 (Sat. & Sun.), 2011
San Francisco State University

REGISTRATION FORM

Please download the form as a PDF or MS Word document or simply print out the form, complete all information, make the proper selections, and mail the form with payment to the address at the bottom of the form. Please note: (1) Advance registration will close February 18, 2011 or when the number of registrations reaches 130; (2) Saturday evening reception will close when the number reaches 70 (due to the capacity limitation).

Name

First

Middle

Last

 

 

 

Affiliation

 

Mailing Address

 

 

Phone No

 

Fax No

 

E-Mail

 

Registration Fees (please mark your choices on the underlines.)

____Advance Registration

____Student: $30 ($20 for one day)

$________

____NCJTA Member: $30 ($20 for one day)

$________

____Faculty/Other: $40 ($30 for one day)

$________

____On-site Registration
(after February 18)

____Student: $40 ($30 for one day)

$________

____NCJTA Member: $40 ($30 for one day)

$________

____Faculty/Other: $50 ($40 for one day)

$________

Saturday Evening Reception
Close when the number reaches 70

Please choose:
____ Will attend
____ Will not attend

 

Saturday Lunch $15

Please choose:
____ Will attend
____ Will not attend

$________

Sunday Lunch $15

Please choose:
____ Will attend
____ Will not attend

$________

Total Amount Enclosed

$________

Note: Participants from overseas (excluding participants from contiguous America and Hawaii) can pay on site but should register beforehand (by February 18, 2011).

Method of Payment: The payment should be by (1) a personal US bank check, or (2) an international money order/bank draft, both payable to:
University Corporation, SFSU (ICPLJ), or (3) a credit card (please contact icplj@sfsu.edu for this option).

Please return the registration form and payment to:

Dr. Masahiko Minami
Dept. of Foreign Languages and Literatures
San Francisco State University
1600 Holloway Ave.
San Francisco, CA 94132
U.S.A.