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Membership Application FormMembership Application Form

FLIP Overseas Membership Application Form

Please complete the following Membership Application Form. (items with * are the required items.)


1 Type of Application*
Application as a new member
Application for readmission
(Select if you applies for readmission after withdrawal from the membership)
2 Language for FLIP Program* Please select the language from either English or Japanese which you want to use for the FLIP programs.
English
Japanese
3 Language for General Technical Support (Q&A Service)* Please select the language from either English or Japanese which you want to use for general technical support (Q&A service) on the FLIP programs.
English
Japanese
4 Type of Member*
Overseas Juridical Person (Company, Organization, University, etc.)
Individual in Overseas
5 Operation Confirmation of LAN connection for FLIP program*(Note1)
Confirmed
Not confirmed (I wish to confirm operation beforehand with the protection dongle for rent)
Not confirmed (I do NOT confirm operation with the protection dongle. There is no problem with LAN connection.)
6 Name of Company, University, etc.* If you apply for the membership as an individual, please enter "Individual Overseas Member".
7 Name of Representative of Company, Universiry, etc.* If you apply for the membership as an individual, please enter "Individual Overseas Member".
8 Name of Responsible Person* Please enter the name of the person who has the authority on admission to the FLIP Consortium Overseas Membership.
9 Title of Responsible Person* (i.e. president, general manager, etc.)
If you apply for the membership as an individual, please enter "Individual Overseas Member".
10 Mailing Address*
11 Country*
12 ZIP code*
13 Name of Contact Person*
14 Prefix of Contact Person*
Mr.
Ms.
Dr.
Prof.
15 Division of Contact Person
16 Title of Contact Person
17 TEL*
18 E-mail*
19 Name of Person for Q&A Service*
20 Prefix of Person for Q&A Service*
Mr.
Ms.
Dr.
Prof.
21 Division of Person for Q&A Service
22 Title of Person for Q&A Service
23 TEL*
24 E-mail*
25 Registration of Additional Person for Q&A Service* Additional person(s) up to nine persons can be registered for Q&A service with additional fee per person.
Need
Not Need
26 Purchase History of FLIP ROSE ver.7 Series (Check if applicable) We/I have FLIP ROSE ver.7 Series
Stand Alone Version
LAN-Compatible Version
Academic Discount Version

Registration in FLIP ROSE Ver.7 Series Support Service Agreement
currently registered
not registered
27 Reference*
(Our International Advisors) (Note 2)
Prof. W. D. Liam Finn
(University of British Columbia, Canada)
Prof. Michael Pender
(University of Auckland, New Zealand)
Prof. Steven L. Kramer
(University of Washington, USA)
Prof. Alain Pecker
(Ecole Nationale des Ponts et Chaussees, France)
Prof. Kenichi Soga
(University of California, Berkeley, USA)
Prof. Masyhur Irsyam
(Institut Teknologi Bandung, Indonesia)
Prof. Meei-Ling Lin
(National Taiwan University, Taiwan)
Prof. Kyle M. Rollins
(Brigham Young University, USA)
(Note 1) The Overseas Member will receive 10 licenses to use the FLIP programs in the load module and can simultaneously run the programs in a maximum of ten computers connected through LAN. Confirmation of operation through LAN before admission will be recommended because the FLIP Programs may be not be available depending on your network environment. If you want to confirm operation through LAN, please check “Not Confirmed (I wish to confirm operation beforehand)”. We will send you a protection dongle for rent for operation confirmation.

(Note 2) Admission to the Overseas Membership is subject to the approval by the president or the director in charge of the FLIP Consortium and needs the recommendation by the reference. Please select one international Advisor from the list as your reference.
Our International Advisors  https://www.flip.or.jp/en/e_advisors.html
Before applying for the Overseas Membership, please check the following "FLIP Consortium Overseas Membership Terms and Conditions" and "Articles of Incorporation".
If you accept the following documents, select the checkbox below and press "Send" button.


"FLIP Consortium Overseas Membership Terms and Conditions" (Download PDF)

"
Articles of Incorporation" (Download PDF)




bunner space

General Incorporated Association
FLIP Consortium

【Office】
Jiji-Press Bld. 5th floor,
185 Nakahori-cho,
Nakagyo-ku,Kyoto 604-0844
Japan

e_info@flip.or.jp