The Japanese Society of Psychiatry and Neurology

Please complete the application form and press the "submit" button below.
Fields marked with an asterisk (＊) must be completed.

Membership Application Year : 2024

If you have been a JSPN international member before, enter your registered e-mail address and date of birth, and click on the [Data insert] button to automatically display the details of your previous registration.
E-mail Address
Date of Birth	/ / ※Day / Month / Year

＊First Name / Given Name
Middle Name
Last Name / Family Name
＊E-mail Address		@
＊E-mail Address (confirm)		@
＊Date of Birth		/ / ※Day / Month / Year
＊Gender
＊Name of Affiliation
Department
Position
Office Address	＊Street
	＊City / State
	＊Postal / Zip Code
	＊Country
	Phone Number
	URL
Home Address	＊Street
	＊City / State
	＊Postal / Zip Code
	＊Country
	Phone Number
＊Specialty		* e.g.) social psychiatry, stress disorder
＊Occupation		* e.g.) psychiatrist, clinical psychologist
＊WPA Member Society		* Member Society of World Psychiatric Association
For JSPN Fellowship Awardee		Award Year / Venue * Venue of the JSPN Annual meeting