IDRiM Member Registration Form

 

Please complete registration information

E-mail address:
First name:
Family name:
Title:
Prof.
Gender: Male Female Other
Nationality:
Affiliation:
Present position / designation:
Research Area/
Research Interests:
Address
Street
(incl. bldg number):
City, State
(incl. ZIP code):
Country
(of your address)
Phone number: country code:   area code:  

number:  
URL
(of your Web page):
Types of membership:
Name any member(s) of IDRiM that you might know :
Write shortly your interest to join IDRiM including possible contribution in promoting IDRiM Society:
 

For more information on membership type and fees please go to: http://idrim.org/?page_id=47

or

  Confirmation will be e-mailed to you automatically, and this page will be replaced by another page with the contents of this e-mail if you select the Register button (please click only once, this process may take up to 2 min.).
If you receive no e-mail with the confirmation, then please double-check (on the next page that appears after registering), if your e-mail address is correct.
We will evaluate your application to evaluate your eligibility for membership in IDRiM and will contact you as soon as possible, but if you not hear from us for over a week, please contact us (office@idrim.jp).
Should the problem persist, then please send an e-mail to the address given at the bottom of this page.
 
 
Comments and suggestions about this form would be most welcome:
office@idrim.jp