MVA2009: IAPR Conference on Machine Vision Applications

Registration Form MVA2009 MVA2009: IAPR Conference on Machine Vision Applications May 20-22, 2009 Keio University, Japan This form should be received no later than March 6, 2009 if the participant presents paper(s), otherwise no later than May 13, 2009. Early registration before April 20, 2009 is recommended for reduced registration fee.

Participant’s Name: (□Prof./ □Dr. / □Mr. / □Ms.) Last First Middle

Affiliation: Job Title:

Address: City State/Country Postal Code

Telephone: Fax: E-mail: Please check the appropriate registration fee. before March 6, 2009 before April 20, 2009 before May 13, 2009 on-site Speaker □40,000 yen Speakers must register by March 6, 2009 (per presentation) Participant (member1) □40,000 yen □40,000 yen □45,000 yen □50,000 yen Participant(non-member) □45,000 yen □45,000 yen □50,000 yen □55,000 yen Non-author student ― □10,000 yen Extra page 10,000 yen / page At least one author for each paper must complete an advance registration as a speaker by March 6, 2009 to ensure that their papers are included in the proceedings. However, it is not necessary to register more than once if you have multiple papers. Just indicate all the paper IDs and total extra pages below.

Paper ID(s): Extra page(s): page(s). Total amount: yen. Payment methods for advance registration:  Bank Transfer: Date of Remittance: (Month/Day/Year)

Bank and Branch Name: Recipient’s Name: MVA2009 Recipient’s Account Number: 1673751 Recipient’s Bank and Branch: Mizuho Bank, Ltd., Roppongi Branch SWIFT code: MHBKJPJT  Credit Card (Participants from outside Japan only): □Master Card □Visa □American Express

Card Number: Exp. Date: (Month/Year)

Signature: Date: For advance registration, send this form to: Katsushi Ikeuchi, Professor Institute of Industrial Science The University of Tokyo Phone: +81-3-5452-6242 4-6-1 Komaba, Meguro-ku, Tokyo 153-8505 Japan Fax: +81-3-5452-6244

1 Reduced member fee is applied if a participant is a member of either one of IAPR regional representative societies or societies cooperating with MVA2009: The Information Processing Society of Japan, The Institute of Electrical Engineers of Japan, The Institute of Electronics, Information and Communication Engineers, The Institute of Image Information and Television Engineers, The Institute of Systems, Control and Information Engineers, The Institute of Image Electronics Engineers of Japan, The Japanese Society for Artificial Intelligence, The Japanese Society for Non-destructive Inspection, The Japan Society for Precision Engineering, The Robotics Society of Japan, The Society of Instrument and Control Engineers, The Virtual Reality Society of Japan