IGCA : New Membership

Application form for IGCA membership

This is the official application form for IGCA membership.
If you would like to become a member, please complete the form below.

Fields marked with * are required.

Personal Information

Name

Family name*

First/Middle name*

Date of Birth

Year/Month/Day

Male

Female

Nationality

Are you a member of JGCA(Japan Gastric Cancer Association)?

Yes

Office Address:

Title/Position

Department

Affiliation (Hospital/Institution/Organization)*

Address*

City/Postal code*

Country*

Phone

Fax

E-mail*

	Please send any correspondence to this address.
	Please do not publish this address in the member’s directory.

Home Address:

Address*

City/Postal code*

Country*

Phone

Fax

Home e-mail

	Please send any correspondence to this address.
	Please do not publish this address in the member’s directory.

Education

Earned degree

School/City /Country/Year degree was received

Specialty

Surgery Chemotherapy Gastroenterology Pathology Basic Science Radiology Immunology Endoscopy Epidemiology Oncology Laparoscopy

Main interest

Annual Membership Dues and Online Gastric Cancer Journal Subscription

Category		Amount

Annual Membership Dues		JPY5,000
Online Journal Subscription*		Free of Charge (exclusive benefit for IGCA members)

Currency code JPY - Japanese yen

*Note1: Gastric Cancer is the official journal co-published with the Japanese Gastric Cancer Association (JGCA). Members of JGCA may also access the journal through the JGCA official website.
*Note2: Once your membership payment is confirmed, we will send you a username and password which will allow you to access the journal's electronic contents.

IGCA Office
c/o Cancer Institute Hospital
3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan
Tel: +81-3-3520-0111 +81-3-3570-0381 Fax: +81-3-3570-0343
E-mail: igca@jfcr.or.jp