Withdrawal Notification

Home Membership Withdrawal Notification

The field marked * is required.
If you want to withdraw from the association during the year and have not completed the payment of the membership fee, you will need to pay it.

Name＜Person name in charge of Corporation Member＞

Membership Number

Classification of members

Regular

Student

Corporation

Withdrowal date

Office name＜Name of Corporation Member＞

Contact details *

Zip-code

Address

Phone No.

e-mail address

Reason of withdrawal