1st Sakura Science Club Alumni Meeting in Indonesia
--Registration & Member List--

1) Do you participate in the alumni meeting? *

Please fill out the registration for the alumni meeting (December 11, 2019) and indicate your willingness to share your information in the member list of the Indonesian SSC members at the bottom before clicking on “Confirmation”. If you participate in the meeting, but you won't share your information in the list, please click on “No” at the question on the bottom, then click on “Confirmation”.

When you are not able to come to the alumni meeting and would like to share your information in the SSC member list, please fill out the personal information #2-#6 and indicate your willingness to share your member information at the bottom before clicking on “Confirmation”

2) Your name in full (with honorifics, Ms. Mr. Dr. etc.) *

3) Your SSP ID

Your ID is shown under your name in the e-mail.

4) City or State of Province *

5) Your current affiliation *

Please specify the name of school, university, organization, etc.

6) Your current position *

7) Do you want to make a presentation at the meeting? *

If "Yes", please fill out the “Column I. and Column II.” in the attached Registration Form, and send it to the secretariat by Friday November 8, 2019.

8) Do you want to be a coordinator of the alumni association in Indonesia? *

If "Yes", please fill out the “Column I. and Column III.” in the attached Registration Form, and send it to the secretariat by Friday November 8, 2019.

Privacy Policy

The SSC Secretariat is planning to make a list of Sakura Science Club Members in Indonesia who are willing to share their personal information with other Indonesian members. The member list shows the name of the SSC member, SSP ID, their current affiliation and position/title, the name of city or state of province, period of SSP participation.
The list will be shared with all Indonesia Alumni members who wish to have its copy. The alumni meeting participants will get a copy at the venue.

I agree to share my personal information as described above.*