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The 10th APRU Population Aging Conference: Registration Form
Keio University will ensure that all personal information entered in this form will be used solely for the purpose of the conference. The privacy policy of the university can be found at the link below:
https://www.keio.ac.jp/en/privacy-policy/
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Last Name
*
Your answer
First Name
*
Your answer
Prefix / Salutation
*
Mr.
Mrs.
Ms.
Mx.
Other:
Name of affiliated University / Organization
*
Your answer
Is your affiliated institution a member of APRU?
*
Yes
No
I don’t know
Department
*
Your answer
Job title / Position
*
Your answer
Which date(s) of the conference will you attend?
*
Sunday October 13
Monday October 14
Required
If you are a co-author to one of the speakers at the conference, please state his/her name here.
Your answer
Why are you interested in attending the conference?
*
I research in related fields
I work in related fields
I am personally interested in issues related to the conference
Other:
Required
How did you hear about this conference?
*
Email from Keio University
Email from APRU
Colleague or acquaintance
Speakers at the Conference
Social Media
Other:
Required
By attending this event, you kindly consent to your picture being used in publicity materials. Your name, email address, title, and affiliation will be added to the APRU database for internal use.
*
Yes I agree.
Required
You further kindly consent to being sent occasional correspondence from the APRU International Secretariat on news, events, or activities relating to population aging.
*
Yes I also agree.
Required
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