Name (*)
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Position & Department |
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Company/ Organization, etc (*) |
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Address |
(*)
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Contact Info |
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I will contribute to a presentation (*) |
: Please write title of your Presentation below
Title of Presentation
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Registration Fee (*) |
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Welcome Reception Attendance (*)
[Oct. 28] |
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Official Dinner Attendance (*)
[Oct. 29] |
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Safari Tour (*)
[Oct. 31] |
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Payment Amount(*) |
Total: USD (Registration Fee & Safari Tour)
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Payment Method (*)
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URL for On-line Credit Card Payment :
https://www.iere.jp/Payment/paypal_19GM.html
*IERE Central Office will send you the invoice by e-mail.
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Invitation Letter for VISA (*) |
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Information from IERE (*) |
Do you agree with receiving e-mail notices on future activities from IERE Central Office?
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Personal Data (*) |
Do you agree to disclose your personal data for the participants list of this forum?
Central Office may enclose `Participants list’in the conference bag to facilitate communication among participants. The list will contain 1. Name, 2.Position, Department, 3.Company/ Organization etc., 4.E-mail address, 5. Country/ Region of this format.
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