1998 ICMTS HOTEL RESERVATION FORM

Deadline: March 7, 1998

Type or print in BLOCK LETTERS.

Name: Prof./Dr./Mr./Mrs./Ms./


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             Last Name        First Name       Middle Initial*


Company/Organization: ---------------------------------------------------


Address: ----------------------------------------------------------------


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         Mail Stop:                       City/State/Country:


Phone: -----------------------------   Fax: -----------------------------


E-mail: ----------------------------------------


Accompanying Person(s) -------------------------------------------------------
if any:                   Last Name                           First Name

Hotel Accommodation:
--------------------

 Hotel           Number of Room(s)               Period of Stay


 Kanazawa    ____________Twin room (s)  Check-in:     ______________
 Citymonde

             ____________Deluxe Single  Check-out:    ______________
                                room(s)

             ____________Single room(s)               ______________ Night(s)


 Hotel Deposit 10,000 Yen per room = ___________________ Yen    (A)


 Communication Fee (Postage etc.)   = _______500________ Yen    (B)
 

Grand Total = (A) + (B) = ___________________________ Yen

 

I am enclosing an international check or money order of the above total
amount in Japanese Yen drawn on a Japanese bank, payable to the
Japan Travel Bureau, Inc.  (Personal checks will not be accepted).

I charge the above total to my credit card.

Record of Charges
-----------------

   Total Amount: _________________________ Yen

   Credit Card Type: Diners / Master Card / VISA / JCB / AMEX

   Credit Card Number:   ______________________________________________

   Expiration Date:       _____________________________________________


   Name as it appears on card:   ______________________________________

   Cardholder Signature:   ____________________________________________

   Date: ________________________

(This application will be valid upon your receiving confirmation from JTB.)