Admission form

Please fill the followings.
The following characters are not allowed.
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Name:(Required field)

Date of Birth:

Year  Month Day

Member Type:(Required field)

Member(Normal) Cooperational Member Student

Address(Univ. or Co.):(Required field)

Address:

Name of Univ. or Co.:

Department:

Phone:

FAX:

E-mail:

Address(Home):

Address:

Phone:

FAX:

Academic background:

Degree：

Select your degree Bachelor Master Ph.D. Others

Comments：