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APLICATION FORM FOR HOTEL
RESERVATION Contact
information(Please PRINT clearly) Tittle: □ Mr, / □ Mrs. Family / Middle Name: First Name:
Company / Affiliation:
Address:
Phone: Fax: Email: Hotel
Reservation information(Please PRINT clearly) Check in date: Check out date: Room type:
□ Single Room □
Twin Room (The name of person for share): Smoking:
□ Non- Smoking / □ Smoking Payment
information (Please PRINT clearly) Type of credit card:□ VISA / □ MASTER Credit Card #:
Expiration date: Name of card holder: Please
fax or Email this application form to following person in chrge by 31
December, 2006. Mr. MORIKAWA |