NEURO2024
Application for Satellite Program

Theme

Theme

Date & Time

Date & Time

Date　　　Time　 〜
　　　　　　　　　　

Venue

Venue name

Host Organization

Organization name

Website

Organizers

*Two organizes' names and affiliations if applicable

Main organizer＊

Name：
Affiliation：
Email：

↓Please enter again for verification. 　　　　　　　　
Phone number：

• -
• -

JNS membership number：
JSN membership number：
JSBP membership number：

Co-organizer

Name：
Affiliation：

Speakers

*For more than 5 speakers, please enter in the comment field at the bottom.

Speaker 1

Name：
Affiliation：

Speaker 2

Name：
Affiliation：

Speaker 3

Name：
Affiliation：

Speaker 4

Name：
Affiliation：

Speaker 5

Name：
Affiliation：

Banner Advertisement

Banner Advertisement on the Meeting Website

• Yes（110 000 JPY（incl. tax））
• No

Registration fees/method, max. number of attendees

Registration fees/method, max. number of attendees

Wish to use rooms of Fukuoka Convention Center. (July 23 - 27)

• Yes
• No

Number of seats*Select if wish to use rooms of Fukuoka Convention Center

• Less than 90
• 90-250
• More than 250

Rental Equipment

Rental Equipment (charged option) *Select if wish to use rooms of Fukuoka Convention Center
*Quoted separately

• Screen & projector
• Microphone
• Poster panels
• PC (Windows)
• PC (Mac)

Program Overview

Program Overview （approx. 540 characters）

Sponsorship

*Please enter if the program is sponsored and will publish the sponsorship.

Sponsor name

Sort of sponsorship

• Co-hosted
• Supported
• Sponsored

Comments

*Please enter if you have any requests for us

Comments