Membership Application Application Form for Overseas Membership - 知の集積と活用の場　産学官連携協議会

Membership Application Application Form for Overseas Membership

会員登録用フォーム（海外版）

E-mailrequired: Please re-enter to confirmation

Name of Corporation / Organizationrequired

Department / Job Titlerequired: "Job Title" is required information

Title

Full Namerequired

Street Addressrequired

Street Address Line 2

Cityrequired

State / Province

Postal / Zip Coderequired

Countryrequired: Please select.

Countryrequired: Please write your country when you select "Others" in the above question.

Home Page

Country Calling Codesrequired

Contact Norequired (Only ascii characters): Please inclulde the country calling code when you select "Others" in the above question.

Business Categoryrequired

Segment

Content of Main Business / Segmentrequired (max 2000 characters)

Purpose of Registrationrequired (max 2000 characters)

Needs of your Corporation / Organizationrequired (max 2000 characters): ※Please be as specific as possible in describing the agricultural, forestry, and marine products you can offer and the technologies you expect to use for cultivation, processing, transportation, quality maintenance technology, evaluation, etc.

Seeds of your Corporation / Organization that you would like to consider utilizingrequired (max 2000 characters): ※Please be as specific as possible in describing the agricultural, forestry, and marine products you can offer and the technologies you expect to use for cultivation, processing, transportation, quality maintenance technology, evaluation, etc.

Others (max 2000 characters)

Privacy Policyrequired

I have read and agree to the privacy policy.

After clicking "Confirm" button below, please check the filled information and click "Submit" button displayed at the bottom of the confirmation page.