The 4th Meeting of Japan-China Neurosurgery Alliance
Registration Form

Please make sure that you will fill in the sections marked *.

If you have any questions, please contact the following.

【 Congress Coordinator 】
Do Convention Inc.
5F, 2-23 Kandaawajicho, Chiyodaku, Tokyo 101-0063, JAPAN
Email:gakkai@doc-japan.com

Contact Information

Name*
Affiliation*
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Country*
TEL*
FAX
E-mail address*
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Password*	(Password must be 4 characters or more)
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Registration

Registrations fee	Regular Participant	JPY15,000

Select registration category*	Regular Participant - JPY15,000
Name on the receipt	* If blank, affiliation which you entered above will be appeared on the receipt.
Upload Student ID*	* Please be sure to upload your student ID card if you choose to be a student. * Please select a file with a file format.

Payment Method

Payment Method*	Credit Card