PMDA-ATC Parhmaceuticals Review Webinar 2025

*Full name

The information you provide here will be used exactly as entered, including upper and lower case letters, for official documents such as certificates and the participants list. Please ensure accuracy.
ex) Taro PMDA [first, then family name]
If your full name exceeds 30 letters including spaces, please shorten to fit within the 30 letters limit.

Male / Female

Male

Female

Calling name (Short name)

Name you wish to be called during the seminar, especially during discussions.

*Job title

*Country

*Organization

*Organization (other)

If you selected "Other" in the preceding section, kindly provide the name of the organization with which you are affiliated.

*Department / Division

*Attendee e-mail address

This will be used for all communications from the Secretariat. Please ensure that it remains accessible while you are traveling overseas and in urgent situations.

*Attendee e-mail address (sub)

Please enter an alternative e-mail address for back up purpose.

Any other e-mail address (If necessary)

Additional e-mail addresses to which copies of communication with the Secretariat should be sent.
(e.g. your supervisor or admin support staff)

*Phone number (Office)

Number with no hyphens“-”

*Phone number (Mobile)

Number with no hyphens“-“

*Name of your supervisor:

All seminar invitees will receive an official letter addressed to their supevisor.
For this purpose, type the full addressee name with honorifics, (e.g. Dr FUJIWARA Yasuhiro).

*The supervisor 's title:

All seminar invitees will receive an official letter. Please type the title of your supervisor here (e.g. Chief Executive, Director-General)

*Your expertise field

*Level of your expertise field

Beginner

Intermediate

Advanced

*Years of experience as a Regulator in the field

Please fill in years of experience as a regulator in the field.

years

*Your current regulatory appointments

Describe your current regulatory appointment in as much detail as possible, within a 300 character limit (including letters, numbers, spaces and punctuation, not 300 words).

*Your expectations

What specific issue you want to address in your work and what aspect you expect to learn from the seminar.
Briefly describe within a 300 character limit. (including letters, numbers, spaces and punctuation, not 300 words)

*Declaration of application

1. Please download the format from the following link; Signature form
2. Please print out the form and have both your signature and your supervisor on it.

3. Please upload the PDF file
→ link to Signature instruction

*Announcement from PMDA

PMDA would like to send announcements regarding PMDA international activities (e.g., PMDA-ATC seminars, PMDA Updates) to your email address.

Do you wish to receive announcements from PMDA?

Yes

No, I do not wish to receive these announcements.

Clause 1

To fully engage in the training activities and make best efforts to achieve the objectives of the PMDA-ATC seminar.

Agree

Clause 2

To comply with instructions by PMDA on confidentiality of information, and not reveal, plagiarize, abuse any person's privacy nor any intellectual property or confidential information which I may learn during the course of my training activities in PMDA and follow instructions on confidentiality.

Agree

Clause 3

To comply with instructions by PMDA on my training activities, and understand that non-compliance or knowingly engaging in inappropriate behavior detrimental to PMDA or the PMDA-ATC seminar may be grounds for termination of my placement.

Agree

Clause 4

To refrain from taking screen grabs/photos/records or produce duplications of seminar material without permission.

Agree

Clause 5

To allow the use of photographs and audio/video recordings taken by PMDA during the seminar at no cost on PMDA's official website, communication material, and presentations by PMDA staff members.

Agree

Clause 6

To allow my presentation slides or related materials submitted to the seminar to be printed and shared electronically with other participants and seminar staff (including but not limited to lecturers, administrative staff, staff at visiting sites.)

Agree