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6th CHEM2ATH CONTEST REGISTRATION

* Please indicate all information collectly. We will communicate the event detail and announcement based on the information you offered.
→ 아래 항목을 입력해주세요. * 표는 필수항목입니다
* Name in English
Please write your name in English. (Last name, First name ex:Hong, Gil Dong)
Name in Korean
Please write your name in Korean. (ex:홍길동)
* High school name
Please write your attending or graduated high school name.
* Grade
Which grade are you in?
* Birthdate
Please indicate your birthdate on the ID card. (yy/mm/dd ex:99/01/30)
* Email
Please write your email address.
* Cell phone number
Please write your cell phone number. (ex:010-9999-9999)
* Home address
Please write your home address with its postal code.
* Companion
Will your parent(s)/chaperon(s) accompany the contest?
Parent's phone number
If your parent or chaperon accompany the contest, please write their cell phone number. (ex:010-9999-9999)
* Recognition channel
How did you get the information about the contest? Please select all channels you got the information.
If you chose 'others'
Please specify.
스팸방지 좌측 이미지의 영숫자를 입력해주십시오