HICARE International Symposium
Commemorating 80 Years since the Atomic Bombing / 35th Anniversary of HICARE
– Registration Form
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Name
姓
名
姓：Family name /
名：Given name
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Email address
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Phone number
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Participation method
On-site
Online
Area of residence
Within Hiroshima Prefecture
Outside Hiroshima Prefecture
Outside Japan
Country (if outside Japan)
Occupation / Affiliation
Medical professional
Researcher
Organization staff
Student
Other
If "Other" please specify
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Consent to use of personal information:
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The personal information you provide will be used only for matters related to this symposium and will not be disclosed or provided to any third party without your consent.
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