Symposium Registration

After completing the input, please click the "Proceed to Confirmation" button and carefully review the details. Once you have confirmed the information, click the "Submit" button. After clicking the "Submit" button, an email containing the registration details will be automatically sent to the email address you provided.

Preferred DateRequired

Both days March 16 (Mon) only March 17 (Tue) only

1.Name (Please answer as First name Family name e.g. John Mckenzie)Required

2.Affiliation and name of the city where you are basedRequired

3.E-mail AddressRequired

4.E-mail Address *ConfirmationRequired

5.Can we share your contact information with other participants?Required

Yes No

6.Could you tell us how you are currently or planning to be involved in activities for SFTS?Required

Government/policy making Practicing medical doctor/nurse Practicing veterinarian/veterinary nurse Other professionals related to clinical works Research (University or public institute) Research (private sector) Medical association Veterinary association Community cat group/animal welfare group/animal welfare group Hunters association Nature conservation group Citizen with potential risk of SFTS infection Other (please specify) Don't want to answer

7.We are planning a networking event (free of charge) on 16th March after the symposium. Please indicate if you are willing to attend. We ask this question for a planning purpose only and you do not have to follow what you indicated here. Also please note that we may have to cancel this networking event in unexpected circumstances. Thank you.Required

Willing to attend Will not attend

8.If you have any other questions, please let us know.