Date: 9-12 October 2014

Venue: Grand Hyatt Shanghai, Shanghai, China

Registration
First
Last
Gende
Prefix*
Suffix Title*
Date*
Name*
Name*
r*
Lin Tongxiang
Gicharu Gibson
Mohamed
Kamau
Hassan
Mohamed
Fadlalla

Tongxiang Lin

Male

Professor

Gibson

Gicharu

Male

Student

Mohamed Fadlalla

Male

Student

*field is compulsory

2.Students include high-school, undergraduate, medical and predoctoral students as wells as

3.The spouse/guest fee covers only meals and the welcome reception. It does NOT admit indi
4.For group registration with more than 10 delegates, AACR will offer 10% discount.

Institution*
Fujian
Agriculture
and
Fujian
Forestry
Agriculture
and
Fujian
University
Forestry
Agriculture and
University
Forestry
University

Email*

CC Email

Spuse /
Guest

Spuse /
Guest Name

lintx69@yahoo.com
gicharukamau@yahoo.com
awnab3@gmail.com

toral students as wells as postdoctoral and clinical fellows. Students registering onsite must show a va
on. It does NOT admit individuals to lecture sessions.
r 10% discount.

Street
Address * Rd, City*
15 ShangXiaDian

Cangshan
District,
Fuzhou
Fuzhou,
Fujian
Fuzhou
350002, P. R. China
Fuzhou

ite must show a valid student ID card.

Province*
Fujian
Fujian
Fujian

Country*

Postcod
Office Phone*
e

Mobile

China

13015768645

China

18120816340

China

18149567057

Fax

Dietary
AACR
Requirements Member*

Membershi New
p Code
Address

Scientific
Primary Area of
Research Focus
Research *
*

Race or
Institution Type
Ethnic
*
Background *

Category*(Advance
Registration before 15 Aug,
2014)

Payment
Method *

Need
Fapiao*

Fapiao
Title*

Fapiao
Conten
t

Mailing
Address

Speical VAT
Fapiao

VAT Fapiao
Content

Chinese
Company Name

Tax No.

Compay
Address &
Number

Company
Issuing Bank
and Account

Need Visa
Invitation Letter
Request*

Full Name
Place
Date of
in
of
Birth
Passport
Birth

Passport
Passpo
Expiry
rt No
Date

Intended
Date of
Entry

Intended
Date of
Stay

General Remark

BiochemistAssociationHispanic or Latino
BiostatisticCancer CenNative American
CarcinogenFoundationNative Hawaiian or Pacific Islander
Cellular Bi GovernmenAfrican American or Black
Chemistry Hospital/MeAsian
Clinical InvIndustry/PrAlaskan Native
ComputatioNonprofit ROther
Endocrinol Other
EpidemioloOther Cancer Center
Genetics and Genomics
Immunology
Molecular Biology
Preclinical Pharmacology and Experimental Molecular Therapeutics
Prevention Research
Radiation Oncology/Radiation Biology
Research Administration/Business Development
Tumor Biology
Virology
Other