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JSPA Student membership/Application form
Complete the form below and press the confirm button.
Name
required
Last name
First name
Gender
required
Male
Female
Other
Date of Birth
required
Year
Jan.
Feb.
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sep.
Oct.
Nov.
Dec.
Month
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Date
Mail Address
required
Please re-enter to confirm.
Enrolled school name
required
Study subject
required
School year
required
1st year
2nd year
3rd year
4th year
Postgraduate
Please attach a photo of your student ID
required
4Mバイトまで
複数ファイルを送るには
Registered address
required
Please enter zip/postal code,street address,town/city,Country.
The registered address will be printed on the member list of JSPA.
(Whether to publish can be selected from the question below.)
Delivery address
If you wish to receive postal delivery from JSPA other than the registered address,please enter the delivery address.
Please enter zip/postal code,street address,town/city,Country.
Contact phone number
required
Country code
-
-
Mobile phone allowed
FAX Number
Country code
-
-
Allow or not to publish your name in the member list of JSPA.
required
allow
not allow
Message if any
confirm