Computational Materials Design Workshop (CMD) Application Form
＜＜ADVANCED COURSE＞＞
Please fill up the ff. form and submit it, by Fax AND E-mail, to: 
	CMD Secretariat, Graduate School of Engineering, Osaka University
	E-MAIL	: cmd@dyn.ap.eng.osaka-u.ac.jp
	FAX	: +81 6 6879 7859
Submission Deadline: 2 August 2009 (SUNDAY) 
1. NAME (Surname, Given Name	
	
2. Gender (Pls. mark with a ○)	 M　・　F    	
3. Affiliation  Name and Division
　　　　　  Street Address
            City
            State
            Postal Code
            Country
　　　　　  TEL
　　　　　  FAX
　　　　　  E-mail	

(     )         -
(     )         -
           @	
4. Position　※		
5. Research Field/Interest		
6. Target Material		
7. Contact Address
(other than affiliation, optional)
　 
　　　　　  TEL
　　　　　  E-mail	

  (       )          -
             @	
8. CHOICE OF CODE
Please refer to the file: CMD-CODE-CATALOGUE-2006.pdf.	
1st choice: Group A (     ), Group B (     )
2nd choice: Group A (     ), Group B (     )
	
9. Motivation for Participating in the CMD Workshop	
※In the field [5. Position], please answer: Prof., Assoc. Prof., M.S. Student (year), Ph.D. student (year) , etc.

MEMO (possible question you may want to ask)