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Application for Student Member
Applicatoin for the Membership of the JSPM (Student Member)
The field marked * is required.
Name (English)
Family Name
Given Name
Middle Name
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Date of Birth
Asia/Tokyo
1. Occupation
Company, University, etc
Department
Section
Grade
Zipcode
Address
Country
Tel. No. (+xx-xx-xxxx-xxxx)
Fax. No. (+xx-xx-xxxx-xxxx)
E-mail
2. Home Address
Zipcode
Address
Country
Tel. No. (+xx-xx-xxxx-xxxx)
3. Education
Bachelor (Institution, Dept., Section, Year of completion)
Master (Institution, Dept., Section, Year of completion)
Doctor (Institution, Dept., Section, Year of completion)
4. Degree
5. Do you want to receive our journal?
Yes, I do.
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6. Destination of Journals, etc.
Office
Home
7. Shipment
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8. Year of Admission
9. Supervisor
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