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オンライン世界一周 参加フォーム Online round-the-world trip Participation form
8月23日（火)19:30〜20:30@zoom
23rd Aug (Tue )19:30〜20:30@zoom *JP time
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* Indicates required question
名前 Name
*
Your answer
性別 Gender
*
男性 male
女性 female
その他 others
Other:
国 Country
*
日本 Japan
Other:
所属 Your profession
*
学生の方は学校名・学年等、社会人の方は職種を差支えなければご記入ください。 For students, please tell us your year and name of your college/university. if you are working, please tell us your occupation.
Your answer
メールアドレス Email address ( Zoomリンクをこちらのメールアドレスに送ります。We’ll send the zoom link to this email address )
*
Your answer
どのようにしてこのイベントを知りましたか？ How did you hear about this event?
*
Twitter
Instagram
キュリーのHP
友人、知人の紹介 Through a friend/ acquaintance
Other:
紹介者のお名前
if you answered through a friend for the previous question, please tell us his/her name
Your answer
質問・要望等ありましたらお願いします！ If you have any questions or requests, please let us know !
Your answer
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