The Japan Petroleum Institute - symposium registration form -

Items with * are to be filled.
You can register maximum 4 participants at one time.
  symposium information
symposium ID 20241127
name of symposium JPIJS lecture meeting
date 2024-11-27
dead line for registration 2024-11-27
payment method* Transfer by bank  
payment will be at (year / month / day):
/ /
Credit card  
annotation *Available credit card: VISA, Master, JCB, Amex
participant ID sending address
representative name* First name

Family name & middle name
organization
affiliation
address category organization home
address*
phone number*
E-mail address*
bill acquired
receipt acquired
comment

  participants
No.1
Name First name
Family name & middle name
Department
Member ID
registration fee
actual place
student
JPY0-		WEB
student
JPY1,100-		actual place
personal member
JPY1,100-		WEB
personal member
JPY2,090-		actual place
corporate member
JPY1,100-		WEB
corporate member
JPY2,090-		actual place
non-JPI member
JPY2,090-		WEB
non-JPI member
JPY3,080-		none
No.2
Name First name
Family name & middle name
Department
Member ID
registration fee
actual place
student
JPY0-		WEB
student
JPY1,100-		actual place
personal member
JPY1,100-		WEB
personal member
JPY2,090-		actual place
corporate member
JPY1,100-		WEB
corporate member
JPY2,090-		actual place
non-JPI member
JPY2,090-		WEB
non-JPI member
JPY3,080-		none
No.3
Name First name
Family name & middle name
Department
Member ID
registration fee
actual place
student
JPY0-		WEB
student
JPY1,100-		actual place
personal member
JPY1,100-		WEB
personal member
JPY2,090-		actual place
corporate member
JPY1,100-		WEB
corporate member
JPY2,090-		actual place
non-JPI member
JPY2,090-		WEB
non-JPI member
JPY3,080-		none
No.4
Name First name
Family name & middle name
Department
Member ID
registration fee
actual place
student
JPY0-		WEB
student
JPY1,100-		actual place
personal member
JPY1,100-		WEB
personal member
JPY2,090-		actual place
corporate member
JPY1,100-		WEB
corporate member
JPY2,090-		actual place
non-JPI member
JPY2,090-		WEB
non-JPI member
JPY3,080-		none

Your personal information for the registration is used only for the management of this event.