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* Items marked with asterisk must be completed.
* Country
* User ID(Email)

※ Please make sure you accurately enter your e-mail address since you cannot modify it later. All future correspondence will be sent to this e-mail address.

* Password
* Confirmed Password
* Name
Given Name : Family Name :

Note

1. Your name will be appeared on your name badge exactly as it is entered in these fields. If you wish your name to be appeared in a specific way, please contact the Secretariat at icksh@icksh.org

2. The first letter of your given name and all the letters of your family name will be automatically capitalized.

* 성명(국문)
* 국문 소속

※ 해당 대학 / 종합병원을 선택하시면 영문 소속명과 주소가 자동으로 입력 됩니다. 소속이 검색되지 않을 경우 직접 작성해 주시기 바랍니다.

*주소
우편번호검색
* 면허번호
* Affiliation
* Department
* Title
* Degree
Address(Work)
* Phone No.
Country Code + -
* Mobile No.
Country Code + -
* Phone No.
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* Mobile No.
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Fax
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Referred by (Name and Affiliation)
Special Request for Food
Invitation Letter
* I required an invitation letter for VISA application.
※ To receive an invitation letter for visa application, please fill out the above field accurately. After making full payment, Please e-mail the secretariat for receiving the soft copy of invitation letter. In order to receive a hard copy of the invitation letter, a requester should send USD 30 for postage to the Secretariat in advance. If you need, please contact the Secretariat icksh@icksh.org by February 28, 2018.
Name on Passport
Given Name: Family Name:
Country (Working)
Passport Number
Date of Birth
Date of Issue
Date of Expiry
Additional Information
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