Participants

Overseas Participants Domestic(Korean) Participants

Category *

ASP Member ASP Honorary President Honorary Advisor Special Advisor ASP Non-Member (Medical Specialists) Resident, Students 정회원 전공의 원로회원 피부과 외 타과

Country *

Select AsiaEuropeNorth AmericaSouth AmericaAfricaOceaniaAntarctica Select

Gala Dinner (Aug. 31)*

Yes No

Special Meal*

의사면허번호

중복확인

※ 면허번호가 잘못 기재되는 경우, 평점이 인정되지 않을 수 있습니다.

국문성명 *

국문소속 *

First Name *

ex) Andrew

Last Name *

ex) LEE
Please write your Last name in the Capital Letter.

Affiliation *

Postal Address

Postal / Zip Code

City

Phone(Work)

incl. country code (ex : 82-2-1234-5678)

Phone(Mobile)

incl. country code (ex : 82-10-1234-5678)

Fax

Email *

ASP Membership Preference

Select Yes No

* This is only for ASP Non-member who did not register yet.

Registration fee

 

Remitter’s Name

Remittance Date

1) This payment method is provided by Eximbay and is billed as www.eximbay.com.
2) Note: Please note that the billing descriptor will be listed as EXIMBAY.COM.

Please confirm the registration details and complete your payment by clicking the payment button on the following page.