Application form

An application form is available for those who wish to join J-SUPPORT. Please fill in all required fields and send the form to us (no application fee is required).

After verifying each application form, the Administrative Office will contact the applicant.

*: Information you input into each application form will not be provided to third parties or used for purposes other than exchanging information and building networks between members.

*: Contact the J-SUPPORT Administrative Office promptly if your contact address (email address) changes after membership registration.


 

Letter of agreement

Yosuke Uchitomi

Chair

Japan Supportive Care Research Group


Dear Dr. Yosuke Uchitomi:

To join the Japan Supportive Care Research Group, I hereby certify that I have read and agree to the terms and Privacy Policy of J-SUPPORT and will comply with the conditions described below. In the event of violation of or disagreement above the conditions, I will not protest any decision that J-SUPPORT makes, up to and including expulsion.

Note

  1.  The use of our group name or abbreviation or any other name that could imply or call to mind our group in business activities is prohibited without permission(Such activities include but are not limited to direct acts of violation, such as listing our group name in commercial products and advertisements, and indirect acts of violation, such as implying the involvement of a J-SUPPORT committee or regular members in the business by, for example, listing our group name in documents and handouts and by mentioning our group name during oral presentation.)
  2. The spirit of this agreement is respected even after withdrawal from membership.

End

 

 

(※): All fields marked with an asterisk (※) are required.

Name (last / first) (※)
Gender (※)
Birthday (※)

Ex :1970/12/06

Email address (※)
Profession (※)








Profession (for “Other”) 
Affiliated institution (※)
Department 
Target group (※)



Research topic of interest (※)































Research topic of interest (for “Other”) 

Do you agree to J-SUPPORT Policy and Privacy Policy of J-SUPPORT and the conditions in a letter of agreement?