www.iarmm.org

Off-line Registration of Your Membership & the Payment

International Association of Risk Management in Medicine

(IARMM)

Mail or Fax to:  IARMM Head Office.

4-7-12-102 Hongo, Bunkyoku, Tokyo, 113-0033, JPN
(Email) head.office01@iarmm.org

(Fax/Tel) +81-3-3817-6770

CHECK ONE.

I am sending about my

(   ) join IARMM

(  ) change personal information, as bellow.  I am a member of URMPM.

(  ) leave IARMM

EMBED YOUR PERSONAL INFORMATION.

Name:

E-mail address (necessary):

Postal address:

Title:

Institution:

Country:

1) In a case of credit card payment, please visit

http://www.iarmm.org/Umembership.shtml

2) BANK TRANSFER for PAYMENT

Send a copy of a receipt of your corresponding payment by fax, email or postal mail.

IARMM Bank Account

Bank name: Bank of Tokyo-Mitsubishi UFJ

Branch name: Hongo Branch

Branch number: 351

Account name: IARMM

Account number: 0111719

Sift code: BOTKJPJT

 Click → List of international branches of Bank of Tokyo-Mitsubishi UFJ

(1) Annual membership fee

	OECD country citizen	non-OECD country citizen
Regular member	150 US$	45 US$
Student member	75 US$	35 US$

(2) Admission fee (for the first year of your membership)

	OECD country citizen	non-OECD country citizen
Regular member	100 US$	30 US$
Student member	50 US$	25 US$

OECD : http://www.oecd.org/

* The membership fee includes your subscription of IARMM international medical journal of ‘Journal of Medical Safety’, and discount fee of IARMM conferences.

C) IARMM 2012