Dermatopathology Club@
application form
(
enrollment, annual fee: free
)
First Name
Family Name
Male/Female
Male
Female
E-Mail
(confirm)
Country
Company(office) Name
Specialty
Agreement with Rules of the Club
Yes I agree with it.
Agreement with Terms of virtual slides
Yes I agree with it.
Where did you get information?
from Friends
on the Seminar by Dr. Kimura
on the lecture by Dr. Kimura
on congress
internet-surfing
others