CHEMINAS 47 発表申込み
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メールアドレス / E-mail address *

参加登録番号 / Registration number

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登壇者の氏名 / Presenter's name

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登壇者の役職,学生の場合は学年(D3, M1, etc.)/ Position, Grade if student (D3,M1, etc.)

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会員種別(入会申込み中の方は申込み中の会員種別を選択) / Membership (If you are in the process of enrollment for membership, select the type you areapplying for.)
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発表タイトル / Presentation title

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全著者の氏名 / Authors' names

日本語表記 (*以下の例をご参考下さい.)
(注1) 姓名の間にはスペースを入れないで下さい.
(注2) 発表者間には「,」(半角カンマ)を入れて下さい.
(注3) 所属が複数になる場合には,氏名末尾に(1), (2), ・・・や(1,2)と番号を付けて下さい.なお所属機関とは,同一の大学で異なる研究科であっても,1つの所属とみなして下さい (その他公的機関,企業等も同様).
(例) 〇〇〇〇(1),△△△△(1,2),◇(1)

In English (Please refer to the following example.)
(Note 1) Use "," between the presenters.
(Note 2) If you include different affiliations, please number them as (1), (2), ..., or (1,2) at end of names. Also, please note that different departments in a same university should be considered as one affiliation (the same applies to public institutions other than universities, companies, etc.).
(e.g.) 〇〇〇 〇〇〇(1),△△△ △△△(1,2), ◇◇◇ ◇◇◇(1)

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全著者の所属 / Authors' affiliation(s)

日本語表記 (*以下の例をご参考下さい.)
(注1) 所属間には「,」(半角カンマ)を入れて下さい.
(注2)   所属が複数になる場合には,所属名称先頭に(1), (2), ・・・と番号を付けて下さい.なお所属機関とは,同一の大学で異なる研究科であっても,1つの所属とみなして下さい (大学以外の公的機関,企業等も同様).
(例) (1)〇〇大学,(2)△△大学,(3)株式会社

In English (*Please refer to the following example.)
(Note 1) Use "," between the  affiliations.
(Note 2) If you include different affiliations, please number them as (1), (2), ..., etc. at beginning of affiliation names. Also, please note that different departments in a same university should be considered as one affiliation (the same applies to public institutions other than universities, companies, etc.).
(e.g.) (1)〇〇〇〇 University,(2)△△△△  University,(3) ◇◇◇◇ Co., Ltd.

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発表の概要(100文字程度) / Abstract (~50 words)

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特記事項(任意) / Requests (Optional)
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