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 20250526
name of symposium The 67th Annual Meeting of JPI
date 2025-05-26 ~ 2025-05-27
dead line for registration 2025-05-12
payment method* Registered mail   Transfer by bank  
payment will be at (year / month / day):
/ /
Credit card  
annotation *Available credit card: VISA, Maser, 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
JPI personal member
JPY5,060-		JPI student member
JPY2,090-		JPI corporate member
JPY7,040-		non-student
JPY3,080-		non-member
JPY10,010-		none
banquet
personal member
JPY8,030-		student / companion
JPY4,070-		none
No.2
Name First name
Family name & middle name
Department
Member ID
Registration fee
JPI personal member
JPY5,060-		JPI student member
JPY2,090-		JPI corporate member
JPY7,040-		non-student
JPY3,080-		non-member
JPY10,010-		none
banquet
personal member
JPY8,030-		student / companion
JPY4,070-		none
No.3
Name First name
Family name & middle name
Department
Member ID
Registration fee
JPI personal member
JPY5,060-		JPI student member
JPY2,090-		JPI corporate member
JPY7,040-		non-student
JPY3,080-		non-member
JPY10,010-		none
banquet
personal member
JPY8,030-		student / companion
JPY4,070-		none
No.4
Name First name
Family name & middle name
Department
Member ID
Registration fee
JPI personal member
JPY5,060-		JPI student member
JPY2,090-		JPI corporate member
JPY7,040-		non-student
JPY3,080-		non-member
JPY10,010-		none
banquet
personal member
JPY8,030-		student / companion
JPY4,070-		none

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