Application Form for Corporate Membership

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	Application Form for Corporate Membership

Affiliation:
Company/organization
Establishment date
Paid-in capital

Name of Representative and title

Description of the business in 100 words

Address:
Number
Street
City
Postal code
Country/State
Office Telephone

Mailing address for invoice
Number
Street
City
Postal code
Country/State

Name of a person in charge
Position/title
Section, Department, Division

Office Telephone
e-mail address

Mailing address for sending journal if it differs from the above
Number
Street
City
Postal code
Country/State
Name of a person in charge

Position/title
Office Telephone
e-mail address
How many lots do you acquire? 10 20 30 40 50

Payment of dues
Initial fee 3,000yen + corporate member dues:
No. of lots x 11,000yen + bank processing fee 4,000yen
Total amounts: yen

How do you want to pay the dues?
I will pay by bank transfer or bank draft

When do you plan to pay the dues?
I will pay the dues (date/month/year)
Do you need a receipt for your payment? Yes No

Click here to send the form to mbs@jsae.or.jp

Click here to clear the form


Membership
	Individual Membership
	Corporate Membership
		Application Form