Registration

Registration fee for SIJM2019 is 10000 yen(major credit card are accepted). Please pay at the venue.
Registration fee for TAS 2019 is 3000 yen. SIJM2019 fee includes TAS fee
Participant's name Dr Prof Mr Mrs Ms
Affiliation
Department
Country
Zip Code
Street Address
Phone
Mobile phone
Email
Accompany companion2 companion3
Date of stay September 26 September 27
Hotel: Hospital inn Dokkyo Medical College
Dinner Get together (26th Sep) Official Dinner (27th Sep)
Participating excursions excursion1 excursion2 Will not participate
Tawara-Aschoff Symposium participate Will not participate
Presentation Yes No
if “Yes”, please Fill up “Abstracts”
Presentation
for Tawara-Aschoff
symposium
Yes No
if “Yes”, please Fill up “Abstracts”
comment
(if you need special meal or any food allergys, pleas inform us)
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