== MLAB Sapporo 2013: REGISTRATION FORM ==

Please complete the form and send by e-mail.

-- Personal information 

Title:    [          ]
(Mr/Mrs/Ms/Prof/Dr/Others)

Position: [          ]
(Researcher/Postdoc/Student/Others)

Name: [          ]

Affiliation: [          ]

Banquet attendance: [       ]
(Yes/No)