JIZAI Web Seminar

Please fill out the application form below.
An invitation to Webiner on Microsoft Teams will be sent out.
* We will happily answer your inquiry on MANI products.
* There is no limit to the number of participants in a session.Please write down the name of the dental clinic or names of the other participants, if any, in the field provided below.

Please fill out the information.

Clinic name

i.g. mani dental clinic

Preferred Date and Time
(First Choice)

Seminars are held from Monday to Friday (9:00 to 20:00).
Excluding Saturdays, Sundays, and holidays.
Example: April 1st, 13:00 ~

Preferred Date and Time
(Second Choice)

Preferred Date and Time
(Third Choice)

Participant Information
(Other Than Yourself)

Please provide information of other participants if any(Dental Clinic Name, Name, etc) i.g. MANI Dental Clinic, MANI John

Questions Regarding Product

If you have any questions regarding our product, please feel free to write them down.

Please register contact information.

First name

Last name

Country of residence

Phone number

Email address

*Double-check your input.
*An automatic confirmation email will be sent to the above email address upon form submission. If you do not receive it within 24 hours, it is possible that your email was not registered correctly. In that case, please contact us directly.

Consent to Privacy Policy

I agree to the Privacy Policy.
We will appropriately manage the personal information you have provided based on the provisions of the Privacy Policy. Additionally, we may use the personal information you have provided to send product information or seminar notifications. For more information on how we handle personal information, please refer to our Privacy Policy.
Privacy Policy

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- Clicking the button alone does not submit the inquiry.
- After clicking the above button, please check the confirmation page before clicking "Submit."