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PRE-APPLICATION FORM

DEADLINE FOR RETURN: Dec., 31, 2004

We, the undersigned, hereby reserve for space as indicated below under the terms and regulations described here *** click and read it!. ***

We will send the original Application Form by mail
after receiving this Form by e-mail.

Name of exhibiting company

Name of person responsible

ZIP

Address

Country

e-mail

URL

TEL

FAX

[A] SPACE RESERVATION:
We wish to reserve a site at A-PACK 2005 Osaka remit our deposit of Japanese yen being 50% deposit forbooth(s).

*We will send you the invoice after we receive this form.
(Remaining amount to be paid by; January 20, 2005)

[B] TYPE OF BOOTH(S) REQUIRED: Please tick appropriate box
*INDOOR
Space & Packaged Shell Scheme
JY350,000/9sqm. Xbooth(s)=JY

Space only(Min. 54sqm.)
JY25,000/1sqm. Xsqm.=JY

[C] TYPE OF SPACE LAYOUT: (in case of 2 stands or more)
Please tick which you prefer

Single lineDouble line

[D] PRODUCTS/SERVICES TO BE EXHIBITED:(please write down in detail)

Exhibits:

Exhibits will be shipped by
air as bonded goods

sea as ATA carnet other

Date

If you have any message, please write down below

Please confirm again!

@

Remarks:
When we receive your application by e-mail, we will send the confirmation mail each time.
If you do not receive our Confirmation by any mail trouble, please kindly contact us by e-mail or Fax mentioned below;

Create Nippo Co., Ltd.
E-mail: info@nippo.co.jp Fax: 81-3-5213-8478