Pre-registration will allow easy entry to the site at the reception counter

Agreement on pre-registration
（If you agree to the following content by ticking the box, you will be able to edit this form.）
Full Name [Required]

First Name

Family Name
Hospital/Facility Name [Required]
Department [Required]
Title
Address [Required] Address1※
Address2
City※
Province / State / Prefecture
Zip/Postal code※
Country※
Tel [Required]
E mail [Required]
※ Please enter your e-mail address once again.

refuse to provide Email address toward exhibitors

Please answer the following questions.

1. Please indicate the type of your organization by choosing one from the list below. [Required]

User
  • Hospital
  • Commercial laboratory
  • Physical examination center
  • Medical research institute
  • Pharmaceutical company - CRO
  • Pharmacy
  • Other
Manufacturer
  • Exhibitor
  • Non-Exhibitor
Dealer
  • Dealer
Other
  • Consultant
  • Student
  • Other
2. What is the purpose of your visit ? [Required]

InstrumentSelect for purchase　　　Information collection
ReagentSelect for purchase　　　Information collection
Information SystemSelect for purchase　　　Information collection
OtherOther　（ In detail: ）
3. Which fields are you interested in? [Required]

  • Clinical chemistry
  • Immunoassays
  • Hematology
  • Microbiology
  • Urine tests
  • Pathology
  • Point of Care testing
  • Physiological function testing
  • Information systems
  • Laboratory automation systems
  • Pre-analysis systems
  • DNA/RNA tests
  • Other　　（ In detail)
4. Your age

  • Under 29
  • 30 - 39
  • 40 - 49
  • 50 - 59
  • over 60
5. How many times have you visited JACLaS EXPO?
　　(Including this visit) [Required]

once　　twice　　three or more times　　

6. How do you know about this Web site? [Required]

Exhibition
  • ADML（AACC）
  • JASIS
Other
  • Web site of JACLaS
  • Other
  • （ In detail ）

※ If you wish to view the security guidelines and privacy policy of JUMBO, who manage the registered information, please click Security policy of JUMBO.