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Apply for Membership Qualification
Classification *

Member (Overseas)

Student Member (Overseas)

Member (Overseas Membership Development Program)

Student Member (Overseas Membership Development Program)
Note
OMDP is for candidates from countries/areas in Asia (except Republic of Korea, Taiwan, China
and Singapore), Africa, Central America and South America, etc.
Personal Information
Full Name
First Name *
Middle Name
Last Name *
Nationality *
Sex *
Male
Female
Title *
Prof.
Dr.
Mr.
Ms.
Date of Birth *
Day
/ Month
/ Year
e.g. 24/12/1970
E-mail
Main *
e.g. sample@example.com
Main (For a check) *
Sub
e.g. sample@example.com
e.g. sample@example.com
Sub (For a check)
e.g. sample@example.com
Mailing Address
Preferred Mailing Address *
Home
Office
Home
Address *
Country *
Phone Number *
Fax Number
Office
Name *
Address *
Country *
Phone Number *
Fax Number
Note Name of School / Company
Academic Background
For Member
The highest academic
degree *
Ph.D.
Masters
Bachelors
Others
Name of
University / College /
School*
Note Name of University / College / School of the highest academic
degree
Date of graduation *
Month
/ Year
e.g. 08/2000
For Student Member
Name of
University / College /
School*
Academic degree *
Note Name of University / College / School you belong to
Ph.D.
Masters
Bachelors
Others
Expected date of
graduation *
Month
/ Year
e.g. 08/2015
Application Information
Period *

April (Applying between February 2nd - August 1st)

October (Applying between August 2nd - February 1st)
Society registration (Membership dues includes one Society of Transaction of
Online version) *

A : Engineering Science

B : Communications

C : Electronics

D : Information and Systems
Additional Societies (Optional)

A : Engineering Science

B : Communications

C : Electronics

D : Information and Systems
Remittance (Remittance is available only in Japanese yen by
a credit card)
IEEE Membership Number *
(8 digits)
IEEE Membership Expiration Date *
Day
/ Month
/ Year
e.g. 31/12/2016
IEEE Membership Card Upload *
If you upload a copy of IEEE membership card (PDF within 1MB), the admission charge is free.
Note Any other file except PDF are not acceptable.
Note Use only English for the file/directory name.
Membership Dues for IEEE Member
Admission charge
¥
(Japanese Yen) Not a number
Membership dues *
¥
(Japanese Yen) Not a number
Additional Societies (Optional) ¥
(Japanese Yen) Not a number
Total ¥
(Japanese Yen)
Credit Card *
UC
Master
VISA
JCB
Credit Card Number *
(15 or 16 digits)
Credit Card Expiration Date *
Month
/ Year
e.g. 12/2016
Full Name of the Credit Card Holder *
American Express
Endorsement
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If you have an endorser, please fill out the IEICE membership number and the name.
Endorser's Number
Endorser's Name
Note Endorser's IEICE Membership Number
Note Endorser's Name
If you don't have an endorser, please fill out the reason for application.
Reason for application
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