PAAL Regular membership Registration

To make a presentation at PAAL conference, you must be a regular member of PAAL.
To be a regular member of PAAL, please fill in the blanks about your information below, and submit it to the PAAL Japan office.
Annual membership fee of PAAL: Regular:￥5,000 Student:\3,500
Our fiscal year is from Apr 1 to Mar 31 of the next year.

Name*	First nameFamily name
Sex*	Male Female
Membership*	Regular Student
Specialty*
Affiliation*	NameDept.Postal CodeAddressTelephone Number (Optional)Fax Number (Optional)
HOME*	E-Mail AddressPostal codeAddress

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