ICTPS Membership Sign-up Form
This form is the Sign-up form for international members of ICT Platform Society (ICTPS).

If you reside in Korea, please visit the Korean website for your membership - http://www.ictps.or.kr

Email address *
Email Address (again) *
Your primary or preferred email address
Your answer
Personal Information
Prefix *
First Name *
First name (Given name)
Your answer
Middle Name
(Optional)
Your answer
Last Name *
Last name (Family name)
Your answer
Academic Degree *
Last name (Family name)
Institutional Information
Affiliation *
Organization, University, Institute, Company, and so on
Your answer
Address *
Room, Building/Dept., Street, State/Province, City
Your answer
Postal Code *
Your answer
Country *
* If you reside in Korea, please visit the Korean website for your membership - http://www.ictps.or.kr
Job Title *
Additional Information
Research Interests *
Please select one or more
Required
Secondary Email Address
(Optional) Your secondary E-Mail Address
Your answer
Cell Phone Number *
+Country Code-000-000-0000
Your answer
A copy of your responses will be emailed to the address you provided.
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