APPLICATION FORM (for Regular Membership)
Full Name (Surname first)
Date of Birth
Home Address
Nationality
Business Organization and Address
Position
Highest Academic Degree Completed
Year of Graduation
Name of Institute or University Graduated
Professional Record (Specialization, brief highlights)
Journal of Marine Engineering Society in Japan (published monthly in Japanese) (please check) □ Necessary □ Unnecessary
Mailing Address (Please check) □ Home address □ Business address
Recommended by (Signature)*
Full Name (Block letters)
Date
Applicant's Signature
Date of Application
I hereby apply for membership of the Marine Engineering Society in Japan.
* Recommender should be a member of the MESJ.
