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
20231025
name of symposium
date
2023-10-25
dead line for registration
2023-10-13
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
student
JPY0-
student
JPY1,100-
personal member
JPY1,100-
personal member
JPY2,090-
corporate member
JPY1,100-
corporate member
JPY2,090-
non-JPI member
JPY2,090-
non-JPI member
JPY3,080-
none
to the bottom
No.
2
Name
First name
Family name & middle name
Department
Member ID
registration fee
student
JPY0-
student
JPY1,100-
personal member
JPY1,100-
personal member
JPY2,090-
corporate member
JPY1,100-
corporate member
JPY2,090-
non-JPI member
JPY2,090-
non-JPI member
JPY3,080-
none
to the bottom
No.
3
Name
First name
Family name & middle name
Department
Member ID
registration fee
student
JPY0-
student
JPY1,100-
personal member
JPY1,100-
personal member
JPY2,090-
corporate member
JPY1,100-
corporate member
JPY2,090-
non-JPI member
JPY2,090-
non-JPI member
JPY3,080-
none
to the bottom
No.
4
Name
First name
Family name & middle name
Department
Member ID
registration fee
student
JPY0-
student
JPY1,100-
personal member
JPY1,100-
personal member
JPY2,090-
corporate member
JPY1,100-
corporate member
JPY2,090-
non-JPI member
JPY2,090-
non-JPI member
JPY3,080-
none
to the bottom
Your personal information for the registration is used only for the management of this event.