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Registration form

Registration Form

Family Name

First Name

Family Name (Phonetic)

Phonetic spelling (Name) First Name (Phonetic)

Membership Type

会員番号　Membership Number

Address

Phone Number

Affiliation Organization (Up to 20 characters)

Department/Faculty

Member (General)

　¥15,000

Member (Student)

　¥2,000

Non-Member (Regular)

　¥25,000

Non-member (Student)

　¥5,000

Upload your student ID (for students only)

Social gathering General Networking Event (General)

　¥9,000

Social gathering Student Networking Event (Student)

　¥3,000

If you are registering for multiple people at once, please enter the names and other information of the other participants here. Also, please include any other comments or information here. Additional Information