ASHS_MEMBER REGISTRATION
※Title
* "Mx." Is a title that does not specify gender.
※Name
姓
名
Please enter in English. "姓" is the family name and "名" is the first name.
※Affiliation
only enter the name of your organization.
※Faculty / Academic field
※Job Title
Ex.) Professors, university teachers, students, researchers, nurses, nursery teachers, etc.
Contact address
※E-mail Address
If you enter an incorrect email address, you will not be able to contact us. Input correctly.
※Country
※Postal code [〒]
※Address
Please enter the building name and room number without omitting them.
※TEL
- -
Other form
Thank you for your application!
This completes the application input.
The application details will be automatically returned, so please check.
Please check the "個人情報の取扱への同意" checkbox below.
Please confirm the above input contents and click the "確認画面へ" button below.
▼▼▼
※個人情報の取扱への同意
個人情報の取扱はこちら
上記の入力内容を確認して「確認画面へ」ボタンを押してください