Venue:  
Hyatt Regency Indianapolis
One South Capitol Avenue,
Indianapolis, Indiana 46204  Tel: (317) 632 1234  

Wednesday, February 27th, 2013
12:00 - 1:30 p.m.    Luncheon Keynote
1:30 - 5:30 p.m.      Conference Program
5:30 - 6:30 p.m.      Networking Reception

REGISTER BEFORE: Friday, February 22, 2013

Contact Information　(代表者のご連絡先)

Regular Full-Time Student (University Photo ID Required)

Additional Names:

Regular Full-Time Student (University Photo ID Required)

Regular Full-Time Student (University Photo ID Required)

Regular Full-Time Student (University Photo ID Required)

Regular Full-Time Student (University Photo ID Required)

Registration Fees

Public (一般)：  $60

Full-Time Students (学生)：$0 (DOES NOT INCLUDE LUNCH PROGRAM - UNIVERSITY ID REQUIRED)
                                                        (昼食プログラムは含みません - 学生証をご提示ください)

Payment Method

Mail Check
Make check payable to　(下記住所まで、小切手をお送りください):　
Japan-America Society of Indiana, Inc
Union Station
39 West Jackson Place, Suite 50
Indianapolis, IN 46225
Online Credit Card　
If you celect to pay by credit card you will be taken to a form immediately after this form has been successfully submitted.
        (下記、お申込みボタンをクリックした後、オンラインでのお支払い画面に進みます)
Send me an invoice
We will send you an invoice soon.
        (ご請求書をお送りさせていただきます。)