mic 入会申込書(賛助会員)

ご入会される場合は下記項目に必要事項をご記入いただき、下の送信ボタンでお送り下さい。
合わせて正入会金5,000円と年会費20,000円を、指定の口座にお振込みくください。
ご入金確認後入会とし、会員名簿、会則ならびに各事業部会のご案内をお送りいたします。
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question