Registration Form: I-House Lecture1

Please read our privacy policy and understand that the personal information included in your request will be handled with care in accordance with this policy.

Registration Form: I-House Lecture

Realizing the “Asian Century”: Challenges and Promise for the Leading Economies

Lecturer: John West (Executive Director, Asian Century Institute)
Date: Wednesday, June 19, 2019, 7:00-8:30 pm (Doors open at 6:30 pm)
Venue: Lecture Hall, International House of Japan
Language: English (without Japanese interpretation)
Admission: 1,000 yen (Students: 500 yen, IHJ members: free)

Your name (First name, Family name)

Title
Mr.Mrs.Ms.Dr.Prof.

Affiliation

Daytime contact number (eg. 03-3470-3211)

*We will contact you by phone only in case of emergency.

E-Mail
*If Gmail accounts are used our e-mail may go into your spam-mail folder.

Registration category
Non-memberStudentIndividual MemberCorporate Member  (Membership number: )

Number of attendee(s) (Please select from the dropdown list)
---1234 or more (please consult)

Additional information, inquiries
(Please type in name(s) and affiliation(s) of accompanying guest(s) if any.)

Would you like to receive our monthly E-news?
---YesNoAlready registered

Questionnaire

Sex　---MaleFemaleOther

Age group　---25 and under26-3536-4546-5556-6566 and over

How did you learn about this program? (Please select from the dropdown list)
---Through this websiteThrough another websiteThrough the I-House E-newsThrough the I-House QuarterlyThrough e-mail, including mailing listsThrough a flyerThrough a newspaper or magazineThrough twitterThrough FacebookThrough a friendOther sources

Other sources (Please specify)

This website uses reCAPTCHA, a free security service provided by Google, to protect our contact forms from spam and abuse. If you are experiencing technical difficulties, please contact us by phone.