Application for membership｜Japan Society of Vocational Rehabilitation

TOP PAGE>Application for membership

The items with asterisk(*) will be posted on the members’ list with your consent.

*Admission（fiscal year）required

Will join from

*Namerequired

Last（family）　
First（given）

*Institutionrequired

*Job Titlerequired

Can be posted on the list Cannot be posted on the list

*Institution Addressrequired

Home Address Institution Address

*Mailing Addressrequired

Address
Address line 2
City
State /Province/Region
Postal/Zip Cord
Country

*TELrequired

FAX

*E-mailrequired

*Field of Practice /
Research Interestsrequired

Can be posted on the list Cannot be posted on the list

【Secretariat】
2-3-1 Matsukadai, Higashi-ku, Fukuoka city, Fukuoka 813-8503, Japan
Kyushu Sangyo University Faculty of Human Sciences
C/O Kurachi Laboratory
Japan Association of Vocational Rehabilitation, Secretariat
Fax: 092-673-5818
E-mail： shokuriha_jimukyoku@vocreha.org