Registration form

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【 Registration Type】 Please select one from among the choices

【 First name 】

【 Middle name 】

【 Family name 】

【 Age 】

【 Gender 】

【 Country 】

【 Affiliation 】

【 Department 】

【 Position 】

【 Contact address 】

Please select one from among the choices

【 Phone number 】
- -

【 Email 】

【 Any fields with special interest in IR】

【 Desired medical procedure 】

【 Years of experience as IR 】
)years

【 Dietary restrictions 】Please select one from among the choices

【 Scholarship 】Please select one from among the choices

【 Visa documents 】Please select one from among the choices

 

 

 

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