Application form for Cultural Trip to Japan

Trip detail can be found here »

If you would like to participate in the trip, please fill out the following application. Please fill out a separate form for each participant. We will get in touch with you within a couple of days.



Early booking savings! Fill out this application today, and you will receive a $50 discount per person.

Participant's Name:
Street Address:
City: State:
Zip Code:
Phone:

Best time to call is:
  Morning
Afternoon
Evening
 
Email address:
Age:
Gender: Male

Female
Nationality:
Note: Depending on your nationality, you may be required to obtain a visa to enter Japan. (A visa is not required if you are a U.S. or Canadian citizen).
Are you interested in an optional third-party travel insurance policy for emergency medical coverage?: Yes

No
Maybe
 
Are you physically able to walk around town (for a few miles)?: Yes
No
   
Please list any medical conditions and/or food allergies:
Other comments: