Scientific Congress

Pre-Registration

Name *

Gender *

Male

Female

Nationality *

Moblie *

E-mail *

Occupation *

Dentist

Non-Dentist

Dental Office(Company) *

Website

Dept

Position

Tel. *

Fax.

※ Please check the relevant. (It is possible to choose Multiple choices.)

Purpose of Visit *

To get Information and Technology

Search for Markets

General Inspection

Other ( Comment : )

Route of Visit *

Invitation or Poster

Through exhibitors

Internet

Magazine

Other ( Comment : )

Pre-registration fee

Dentist	Non-Dentist
USD 80	USD 60

Payment information

Registration fee
Credit card

※ Cancellation of registration and refund are possible up to a week before the Scientific Congress and refunds due to cancellation of registration and absence are not possible after that.
※ Please note that the billing descriptor will be listed as EXIMBAY.COM

We would like to collect and use your personal information for the following purpose

- Purpose of Collection and Use

: We would like to collect and use your personal information for the purpose of verifying your identity for participation in GAMEX and providing event-related information.

- Items of Personal Information to be Collected

: Name, Nationality, Address, Email Address, Phone Number

- Retention and Use Period of Personal Information

: You agree to the retention and use of personal information, and it will be promptly disposed of after achieving the purposes related to GAMEX participation.

I hereby consent to the collection and use of personal information for the above purposes.