Participants are requested to fill out the registration form and email it to firstname.lastname@example.org along with the bank transfer receipt for the registration fee, with the registrant's name stated. Registration Form
Registration confirmation will be given by the secretariat via email upon receipt of the registration form and the bank receipt.
Registration Form（Download） → Word or PDF
□ Physicia □ Trainee □ Nurse □ Researcher
□ Student □ Survivor □ Accompanying Person □ Industry
Cell Phone Number: Passport No.:
(before Sep. 16, 2016 )
(after Sep. 17 , 2016)
(October 8-9, 2016)
＊ The asterisk indicates the 4th Congress of the Japan Oncoplastic Breast Surgery Society, October 6-7, 2016, co-participant.
All payments should be made via bank transfer.
Beneficiary Bank Name: SUMITOMO MITSUI BANKING CORPORATION
SWIFT BIC Code: SMBC JP JT
Beneficiary Bank Branch Name: HATANODAI BRANCH
Beneficiary Bank Address: 1-4-15, Hatanodai, Shinagawa-ku, Tokyo, Japan
Bank Informaion in Japanese is here
Please note that all bank transfer fees will be covered by the registrants.
Please send the registration form along with a photocopy of the bank transfer receipt electronically.
Beneficiary Name: DAINIKAI ASIA NYUGAN KANFARENSU KAICHOU NAKAMURASEIGO
Account Number: 7357100
Beneficiary Address: 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, Japan
c/o Showa University School of Medicine Division of Breast Surgical Oncology
Cancellation must be notified to the secretariat via email.
All refunds will be made after the conference.
The bank handling charges and administrative fees will be deducted from the refunds.
|By September 16, 2016||From September 17, 2016|
|50 % Refund||No Refund|
Secretariat of ABCC 2016
Email address email@example.com