Registration form for the 21st Game Programming Workshop

Name:

Sex: male / female

Do you have a presentation in the workshop?
 a) Yes.
 b) No, but I am a coauthor of a paper in the workshop.
 c) No, I am just a participant.

Address:

Tel:

Fax:

E-mail:

Are you a student?
  Yes / No

Are you going to stay in the workshop venue during the whole period?
  Yes / No

If no, please complete the following table.
  Nov. 4 Supper:        Necessary / Unnecessary
  Nov. 4 Accommodation: Necessary / Unnecessary
  Nov. 5 Breakfast:     Necessary / Unnecessary
  Nov. 5 Lunch:         Necessary / Unnecessary
  Nov. 5 Supper:        Necessary / Unnecessary
  Nov. 5 Accommodation: Necessary / Unnecessary
  Nov. 6 Breakfast:     Necessary / Unnecessary

Would you like to take a smoking room if possible?
(Smoking is not allowed in the conference room.)
  Yes / No

Do you need a receipt?
  Yes / No

If yes, do you need two separate receipts for the workshop and
accommodation fees?
  Yes / No

Do you have any special requests?