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Here's an ICLP'95 registration form (LaTeX, 1 page) for non-email
registration.

Related articles on ICLP'95 are as follows:

Welcome to ICLP'95:       <UEDA.95Mar24210824@brie.ueda.info.waseda.ac.jp>
Advance Program:          <UEDA.95Mar15214327@brie.ueda.info.waseda.ac.jp>
General Information:      <JIRO.95Mar23115949@aria.softlab.is.tsukuba.ac.jp>
E-mail registration form: <JIRO.95Mar24121515@aria.softlab.is.tsukuba.ac.jp>


Kazunori UEDA, ICLP'95 Conference Co-chair (ueda@ueda.info.waseda.ac.jp)
Department of Information and Computer Science, Waseda University
================================(cut here)==================================
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\begin{document}
\advance\baselineskip-2pt
\lineskip1pt

\hbox to\hsize{
\begin{minipage}[t]{7cm}\advance\baselineskip-2pt
{\bf ICLP'95 REGISTRATION FORM}\\[5pt]
{\bf Twelfth International Conference\\
on Logic Programming}\\[5pt]
Shonan Village Center\\
Kanagawa, Japan\\[5pt]
June 13--18, 1995
\end{minipage}
\hfill
\begin{minipage}[t]{8.5cm}\advance\baselineskip-2pt
{\sl Please print or type, tick your choices, 
and return the form WITH YOUR PAYMENT to:}\\[3pt]
Dr. Mutsumi Imai\\
Keio University at Shonan-Fujisawa\\
5322 Endoh, Fujisawa, Kanagawa 252, JAPAN\\
Fax:   +81-466-47-5350\\
Email: iclp95@tom.sfc.keio.ac.jp
\end{minipage}}

\vspace{1.5mm}
\hrule
\vspace{1.5mm}

{\offinterlineskip
\halign{#\hfil&&#\cr
Name:       &\blankstrut\hrulefill\span\omit\cr
    &{\footnotesize (Last)\hfill (First)\hfill (Middle)\hfill}\span\omit\cr
Affiliation:&\blankstrut\hrulefill\span\omit\cr
Address:    &\blankstrut\hrulefill\span\omit\cr
            &\blankstrut\hrulefill\span\omit\cr
Telephone:  &\blankstrut\hbox to6.75cm{\hrulefill} &
    Fax: \hbox to6.75cm{\hrulefill}\cr
E-mail:     &\blankstrut\hrulefill\ &
    ALP Member No.: \hrulefill\cr
Dietary Restriction: \blankstrut
   \tickbox\ None\quad\tickbox\ Vegetarian\quad\tickbox\ Other (\hfill )%
\span\omit\span\omit\cr}}

\vspace{1.5mm}
\hrule
\vspace{1.5mm}

\halign{\hfil#\ \ &\hfil#\ \ &\hfil#\ \ &#\hfil\cr
{\bf Conference Fee:}&{\it before May 15}&{\it after May 15}\cr
({\rm ALP member})& 42,000 yen& 48,000 yen&(give your member number above)\cr
({\rm Non-member})& 45,000 yen& 51,000 yen\cr
({\rm Student})&    21,000 yen& 24,000 yen\cr
{\bf Workshop Fee:}& 3,000 yen&\omit\span
     (ICLP participants) / 6,000 yen (workshop-only participants)\cr}

\halign{#\hfil&\hbox to3.0cm{\blankstrut\hrulefill} #\hfil\cr
I will attend the conference:&yen.\cr
I will attend the workshop
\tickbox\ W1/ \tickbox\ W2/ \tickbox\ W3/
\tickbox\ W4/ \tickbox\ W5: &yen.\cr
I will pay the total registration fee of&yen by:\cr}

\halign{#&#\hfil&#\hfil\cr
\ \tickbox\ &Credit card ( \tickbox\ MasterCard/ \tickbox\ VISA).
             Card No.: \blankstrut\hrulefill\span\omit\cr
            &Cardholder's Name: \hbox to5.75cm{\blankstrut\hrulefill} &
             Expiry Date: \hbox to4.0cm{\blankstrut\hrulefill}\cr
            &Signature: \blankstrut\hrulefill\ & Date: \blankstrut\hrulefill\cr
\ \tickbox\ &Money transfer to ICLP95 (copy of order enclosed).\span\omit\cr
\ \tickbox\ &Cheque payable to ICLP95, written in Japanese yen (enclosed).%
             \span\omit\cr
\ \tickbox\ &On-site payment at late fee (Please provide your credit-card
             information above.\span\omit\cr
            &The full fee will be charged to no-show registrants.)\span\omit
             \cr}

\vspace{1.5mm}
\hrule
\vspace{1.5mm}

{\bf Housing Request} --- (If you would like us to arrange rooms, please fill
in the items below.  Requests will be processed in the order they are
received.)

Arrival Date: \blankstrut\hrulefill\ Time: \hrulefill\
Departure Date: \hrulefill

\halign{#&#\hfil\cr
\noalign{\vspace{3pt}}
\noalign{\strut Please reserve}
\ \tickbox\ &a single room.\cr
\ \tickbox\ &a twin ( \tickbox\ Economy/ \tickbox\ Standard/
             \tickbox\ Maisonette) room to be shared with:\cr
            &(specify name) \blankstrut\hbox to7cm{\hrulefill} .\cr
\noalign{\vspace{3pt}}
\noalign{\strut If a room I prefer is not available,}
\ \tickbox\ &I ( \tickbox\ Mr./ \tickbox\ Ms.) am willing to share an Economy
             Twin or Twin room with someone else\cr
            &(arrangement will be made by the Organizing Committee).\cr
\ \tickbox\ &I would like an upper-class twin room at the Conference Site.\cr
\ \tickbox\ &I would like a \tickbox\ single/ \tickbox\ twin room at a hotel
             outside the Conference Site.\cr}

\end{document}