Application Form

                              YITP Workshop on 
     
                       "New Aspects of Strings and Fields"

                    Yukawa Institute for Theoretical Physics

                             November 16th-18th, 1998
 

-------------------------------------------------------------------------------
Complete Name:
                  
Sex: [ ] M,  [ ] F

Institution/Affiliation: 

Status: [ ] Student [ ] Postdoc [ ] Faculty/Staff

Contact Address:

E-mail Address:


-------------------------------------------------------------------------------
1. Do you wish to give a short contribution? 

[ ] Yes,

Title:
Abstract:


[ ] No.



2. Do you wish to make a lodging reservation?

[ ] Yes,

From ___ night To ___ morning

    [ ] A) Kitashirakawa Dormitory 
        [ ] single (2400/night)
        [ ] twin (1600/night)

    [ ] B) Other Hotel (about 5500-7000yen/night)


[ ] No.


*) The nubmer of the rooms available at the Kitashirakawa dormitory is rather 
limited. There is a possibility to share the twin or to reserve B).



3. Do you wish to be supported by the budget of the workshop.

[ ] Yes

[ ] No