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Fax this form at +81 52-581-5585 or email it at [email protected] to the office for ISPlasma2017/IC-PLANTS2017 (person in charge: Mr. Suzuki) Date: _______________ Letter of Acceptance on Corporate Aid to ISPlasma2017/IC-PLANTS2017 We accept to provide corporate aid to ISPlasma2017/IC-PLANTS2017. Japanese (if any) Company name English Amount of aid money Unit: 10,000 yen × units = On or about When you will pay yen (Enter the date.) * You are kindly requested to pay by bank transfer by Tuesday, February 28, 2017. Name and address where bills, etc. must be sent Name of the person in charge (position & section) Phone Fax Email Would you like to have the link to your company’s website posted on our website? URL of your company’s website (*Only when you answer the above question “Yes”) Your company’s logo Yes No Website in Japanese: Website in English: Available Not available * If it is available, please provide us with the file of your company’s logo later. Subject name on the bill (if you would like to designate it) * If you leave this column blank, the subject name on the bill will be “Aid to ISPlasma2017/IC-PLANTS2017.”