| Full name Required | The information you provide here will be used exactly as entered, including upper and lower case letters, for official documents such as certificates and the participants list. Please ensure accuracy.
If your full name exceeds 30 letters including spaces, please shorten to fit within the 30 letters limit.
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| Male / Female | |
| Calling name (Short name) | Name you wish to be called during the seminar, especially during discussions.
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| Job title Required | |
| Country Required | |
| Country_other Required | |
| Organization Required | |
| Organization Required | |
| Organization Required | |
| Organization (Other) Required | |
| Department / Division Required | |
| Where are you based? Required | |
| Applicant e-mail address (main) Required | This will be used for all communications from the Secretariat. Please ensure that it remains accessible while you are traveling overseas and in urgent situations.
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| Applicant e-mail address (sub) Required |
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| Phone number (Office) Required | |
| Head of Organization 1) Name: Required | All seminar invitees will receive an official letter addressed to their affiliated organization’s Head.
For this purpose, type the full addressee name with honorifics,
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| Head of Organization 2) Title: Required | All seminar invitees will receive an official letter. Please type the title of your affiliated organizations’s Head here.
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| Your expertise field | |
| Your expertise field (other) | |
| Level of your expertise field Required | |
Years of experience as a regulator in the field
| Please fill in years of experience as a regulator in the field.
years |
| Your current regulatory appointments Required |
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| Your expectations Required |
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| Declaration of application Required |
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| Travel arrangement by PMDA Required |
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| Passport Required | Do you have a valid passport?
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| Surname Required | Please enter Surname (Family name) written in your passport.
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| Given name Required | Please enter Given name (First name) written in your passport. |
| Visa application (1) Required |
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| Visa application (2) Required | If No, please check your answer.
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| Health condition Required | Can you participate in the seminar without any specific medical assistance during your stay in Japan?
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| If it is No, please enter a comment. | |
| Annoucements from PMDA Required |
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