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Online registration form
Thank you for your interest. To register for 4th APG Symposium & 9th EADC please fill out the form below.
The fields marked * are compulsory.
DELEGATE’S INFORMATION
Prefix
*
Mr.
Ms.(Mrs.)
Prof.
Dr.
Given Name
*
Family Name
*
Organization/Company
*
Position/Job title
*
Postal Address
*
City
State/Province
Zip/Postal code
*
Country
*
Phone
*
Fax
Email address
*
Nationality
Passport No.
*
Dietary requirements
*
a. None
b. Vegetarian (only vegetables)
c. Vegetarian (vegetables and sea foods)
d. Halal
e. Others (please specify your dietary requirements)
I agree to the publication of my name, nationality and company in the List of Participants on the 4th APG Symposium and 9th EADC Website.
*
Yes
No
REGISTRATION DETAILS (The registration fee are payable in JPY.)
Delegate
¥60,000
Accompanying persons
¥30,000 / person
person(1〜3)
Accompanying persons must be a family member.
1.
Given Name
Family Name
Passport No
Gender
Male
Female
2.
Given Name
Family Name
Passport No
Gender
Male
Female
3.
Given Name
Family Name
Passport No
Gender
Male
Female
Technical Tour
¥25,000 / person
Attend
person(1〜4)
T-1 Half day City tour
person(1〜4)
S-1 Welcome reception
person(1〜4)
S-2 Farewell Banquet
person(1〜4)
HOTEL RESERVATIONS
You can make a hotel reservation on this site.
Royton Sapporo Hotel, they have twinrooms only.
Date of Check in
Date of Check out
night
rooms
(1〜3)
room1
smoking_type
*
non-smoking
smoking
use
*
Choose use
Single Use ¥15,000
Double Use ¥20,000
Triple Use ¥27,000
room2
smoking_type
*
non-smoking
smoking
use
*
Choose use
Single Use ¥15,000
Double Use ¥20,000
Triple Use ¥27,000
room3
smoking_type
*
non-smoking
smoking
use
*
Choose use
Single Use ¥15,000
Double Use ¥20,000
Triple Use ¥27,000
TOTAL AMOUNT
All payments shall be made in Japanese Yen (JPY) by bank transfer.
All currency exchange charges and bank fees are the responsibility of the remitter.
TOTAL AMOUNT (provisional)
ARRIVAL ― DEPARTURE
Will inform later
Arrival Details in Chitose Air Port
Origin Airport
Airline
Flight No.
Date
Time
Departure Details from Chitose Air Port
Airline
Flight No.
Date
Time
return