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Icgdr membership Application Form Member organization


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ICGdR Membership Application Form
1. Member organization

Name of your organization


Postal Address



E-mail:

Tel:

Fax:


2. Representatives to the ICGdR Board

For Representative:

Name and position in your organization




E-mail:


Tel:

Fax:

For Alternative Representative:

Name and position in your organization




E-mail:


Tel:

Fax:


3. Description of Membership Organization

Outline of your organization


4. Payment of Membership Fee

Please send the registration form to ICGdR Secretariat and credit the membership fee to ICGdR Bank Account. Currency of membership fee should be one of USD, EURO and JPY.


ICGdR Bank Account:

MIZUHO Bank, MATSUE Branch

Swift Code: MHCBJPJT

Account Name: International Consortium on Geo-disaster Reduction

Account Number for EURO: (630) 9109730

Account Number for USD: (630) 9109722

Account Number for JPY: (630) 1738356



Secretariat of International Consortium on Geo-disaster Reduction
Project Center on Natural Disaster Reduction

Shimane University

1060 Nishikawatsu-cho, Matsue 690-8504, Japan

Facsimile: +81-852-32-9878, Telephone: +81-852-32-9878

Web site: http://icgdr.org/icgdr/

E-mail: wangfw@riko.shimane-u.ac.jp, secretariat@icgdr.org 






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