Please fill in the items below in English. Fields indicated with asterisks(*) are required. For those who have problems with the on-line registration process, please contact the Organizing Secretariat directly (jkcos2018@acplan.jp).
Participant
Title*
First Name* (e.g. Haruhiko)
Last Name* (e.g. Akiyama)
Mailing Address*  
Department*
Institutional/Corporate Affiliation*
Street*
City/State*
Post Code*
Country*
Telephone* (e.g. +81-75-611-2008)
E-mail*

Please enter your e-mail address again for confirmation.

Note) Registration acknowledgement will be sent to this e-mail address.

Name of Accompanying Person(s)
AP1
AP2

Registration

Category Early Registration
(Before May 10, 2018)
On-site Registration No. of participant(s)* Amount
M.D. or Equivalent JPY 20,000 JPY 25,000 JPY 
Fellow/Trainee JPY 10,000 JPY 15,000 JPY 
Accompanying Person JPY 10,000 JPY 15,000 JPY 

Social Programs and Tours **Advanced Reservation Required

Please select the appropriate amount according to the number of participants.
Date Fee No. of participant(s)* Amount
Golf Tour** Jun.14 JPY 20,000 JPY 
Official Tour** Jun.14 JPY 8,000 JPY 
Accompanying Persons' Tour** Jun.15 JPY 5,000 JPY 
Banquet Jun.15 JPY 5,000
JPY 8,000 (On-site Registration)
JPY 
Cormorant Fishing on the Nagara River** JPY 3,100 JPY 
1-day Optional After-Symposium Tour** Jun.16 JPY 15,000 JPY 
Total Amount JPY

Remittance*(Payment should be made in Japanese Yen.)

VISA or Master Card is available
Card
Card Number
Enter your 16 digit card number without spaces or dashes
Card Holder's Name
Expiration Date / (month/year)
Security Code (The last 3 digits on the reverse side of the card)

Requests/Messages (if any, up to 200 characters)