The 3rd International Workshop on Digitization and E-Inclusion in Mathematics and Science 2016 (DEIMS2016) Registration Form Please fill out this application blank for items 1 - 4 and send it to Deims2016-office@mail.sciaccess.net by Jan. 10, 2016 (JST). 1. Basic Information: Name: Affiliation: Mailing Address: Phone: Fax: E-mail: Your Stay in Shonan Villege Center: Feb. - , 2016 Special Notes to the DEIMS2016 Office: 2. Accommodation: In principle, all the participants in DEIMS2016 are assumed to stay at Shonan Village Center (SVC) that is the venue of the workshop. To book SVC rooms, please complete all fields of another application form and send it by e-mail to: Deims2016-office@mail.sciaccess.net by Jan. 10, 2016. 3. Welcome Dinner on Feb. 5, 2016: We will have a social gathering for dinner on Feb. 5 evening. Participation will cost about 6,000 Yen. In terms of a person who stays at Shonan Village Center, this dinner will be regarded as one on that day. Please choose one of the following and let us know with this form. I want to participate. Number of participants: I donft want to participate 4. Excursion on Feb. 6: After closing the workshop, in the Feb. 6 afternoon, we are planning a half-day excursion around Kamakura which is well known as a beautiful ancient city. We believe you will be able to enjoy a wonderful time in Japanese winter. You can find more detaild information at: http://shonan-village.co.jp/svc/access.html. Participation in the excursion will cost around 8,000yen including a dinner. Please choose one of the following and let us know with this form. I want to participate. Number of participants: I donft want to participate Thank you very much for your registration. DEIMS2016 Office The workshop contact e-mail address: deims2016-office@mail.sciaccess.net Web Site: http://workshop.sciaccess.net/DEIMS2016