No.              
                                                                     (Do not write in this space)

Registration Form for Cloud Imagery Utilization Station 

(Please write in block letters and check the applicable boxes)

Name of user:		                                                           

Organization (if applicable):	                                                           

Mailing address:		                                                           

Point of contact  	Name:  	                                                    

Affiliation:  	                                                    

Phone number:	                                                    

Fax number:  	                                                    

E-mail address: 	                                                    

  Registration of utilization station to receive cloud imagery obtained by and distributed via JMA’s MTSAT

　Application type:

     I am registering a new utilization station
     I am reporting a registered utilization station change
     I am reporting a registered utilization station closure

Type of utilization station:

	    Medium-scale Data Utilization Station (MDUS)
	    Small-scale Data Utilization Station (SDUS)

Location of utilization station (receiving equipment):

Address:	                                                                  

Latitude:	        degrees         minutes         seconds    N/  S

Longitude:	        degrees         minutes         seconds    E/  W

Purpose of utilization:		                                                           

Receiving system  	Manufacturer:	                                                    

Model: 	                                                           

Date of commencing operation: