WIC Membership
Welcome to Join WIC
Please complete the following form, and then click the "Submit" button.
The Type of The Membership:   Help
Free Membership No Year Limit
Student Membership 1 Year 3 Years Individual Membership 1 Year 3 Years
Institutional Membership 1 Year 3 Years Golden Membership 1 Year 3 Years

Registrant Information
Title (e.g. Mr., Mrs., Ms., Miss, Dr, Professor, ...)
Name
First name:
Last name:
Affiliation
Country
Email (one only please)
Retype Email

The Payment Method
Cheque (Check) (US Dollars Only)
Please send the cheque to the following address:
Prof. Ning Zhong (WIC)
Dept. of Information Eng.
Maebashi Institute of Technology
460-1 Kamisadori-Cho, Maebashi-City 371-0816
Japan
Transfer (US Dollars Only)
Account:
Acc. number: 310-704444
Acc. name: WIC
Bank/Branch name: the Maebashi Branch of the MIZUHO Bank
Address: 2-1-14 Hon-Machi, Maebashi-Shi, Gunma, Japan

VISA Card Master Card (Japanese Yen Only)
Card Number:
Expiration Date:/
Name Exactly as Shown on Card:

For Individual, Institutional, and Golden Membership Only
Mail Address

For Institutional and Golden Membership Only
Home Page URL

Any inquiries, please contact WIC office.

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