Registration Form
After you complete the registration, notification e-mail (from
jspd58@kokuhoken.jp
) will be sent to you automatically. Please print out the e-mail and bring it to the registratio desk on site.
The deadline for registration is
March 25.
Registration Form
First name
Required
Last name
Required
Name of Affiliation
Required
ex. Koku University Graduate School of Dentistry, Koku Dental Clinic
Div. / Department
ex. Department of Special Needs Dentistry
E-mail address
Required
E-mail address (for Confirmation)
Required
Category
Required
Dentist (12000JPY)
Para-dental (6000JPY)
Banquet
Required
Attend (7000JPY)
Not Attend
Please click the "Confirm" button and check your information carefully.
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