Member Registration – 特定非営利活動法人

Application Form

Membership Type (required)

Corporate Member

Supporting Member

Application Date (required)

Name of Corporation / Organization / Individual (required)

Name in Katakana (for Corporation / Organization / Individual)(required)

※ If the information is the same as the individual’s information above, no need to fill in again. Representative’s Name(required)

※ If the information is the same as the individual’s information above, no need to fill in again. Representative’s Name (in Katakana)(required)

Address Line 1 (required)

Address Line 2

Address Line 3

Pincode (required)

Prefactures

City Town

Phone Number (required)

Website URL

Industry / Business Description

Contact Person’s Name(required)

Contact Person’s Department / Title(required)

Contact Person’s Email Address(required)

Contact Person’s Phone Number(required)

Details of Requested Support (please specify)

Password (required)

Confirmation of Information Email (required)

Would you be willing to receive informational emails from our association?