NEURO2024
Visa Application Documents Request Form

NEURO2024 supports visa application only for those who have completed abstract submission.
Please enter the following fields and click on the "Confirm" button at the bottom.
The fields marked with * must be filled in.

Applicant's Information
Nationality –

Embassy or Consulate you are going to visit for VISA application – Please write an official name of embassy or consulate.

First name –
Alphabet:                           
Chinese character (if any) :  
Family name –
Alphabet:                           
Chinese character (if any) :  
Presentation number or abstract submission number– e.g. 1P-999 or C999999

Sex –
Date of birth (Day/Month/Year) –
Day / Month /Year
Age –

Affiliation –

Position –

E-mail –

«Please type again for confirmation.

Flight Information
Flight information
(to Japan) – Please write an official name of the airport which you arrive at.
Date of arrival:

Airport:
From@
To @@
Airline & Flight number:

Flight information
(from Japan) – Please write an official name of the airport which you depart from.
Date of departure:

Airport:
From@
To @@
Airline & Flight number:
Contact number
Contact number during your stay in Japan –

Accommodation
Accommodation in Japan –
1. Hotel:

Address:

Tel:

2. Hotel:

Address:

Tel:

3. Hotel:

Address:

Tel:

Itinerary in Japan
NEURO2024 can support your stay in Japan before and after the meeting as well as during the meeting, and we can support maximum 7 days (4 days for the meeting + 3 additional days).
Full Itinerary in Japan
  Date Itinerary
e.g.1
e.g.2
Day 1:
–
Day 2:
–
Day 3:
Day 4:
Day 5:
Day 6:
Day 7:
Day 8:
Day 9:
Day 10:

Contact Address
Please fill in the address of either home or affiliation, where you wish to receive the documents.
Contact Address
(Home or Affiliation)
Affiliation (Institution,University etc.): –

If you selected "Home", please fill in "none".
Position: –

If you selected "Home", please fill in "none".
Address: –

ZIP: –

Tel: –

Fax:

Remarks (if any)
Remarks (if any)

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