[Please specify the applicant’s country]
(e.g., South Korea, United States, Germany)

[Full name]
(e.g., John Smith)

[Please select your desired attendance date based on the schedule above.]
* The maximum number of participants per day is limited. Attendance will be confirmed on a first-come, first-served basis.

[Please select your desired attendance Clinic Visit based on the schedule above.]
* The maximum number of participants is limited. Attendance will be confirmed on a first-come, first-served basis.