A Vist to Japan - 2018
Sign up for this trip

 

This form serves two purposes: 1) to sign up for the trip and 2) to supply information to build your personal web page on this tripsite. Once you are successful, the webmaster will integrate your page into the site.

Because we build a separate page for each traveler, we need each traveler to submit their own form: one per person, not one per family or group.

If you have any difficulties, please contact me, Steve Comstock, at steve@trainersfriend.com and I will fix the problem.

 

* - indicates a required field

 

 Your information 

* Your first name ("given name")
* Your last name ("family name")

  Gender (M/F):          Birthday. Year (yyyy):   Month (mm):   Day (dd):  

* Email address:  

  File name for picture:    
  (do not worry if your picture does not fit right: I will adjust it personally when I get it)

 

 Trip options 

Are you planning to include the pre-trip extension to Kanazawa? Yes   No
Are you planning to add any trip extensions of your own?        Yes   No  

 

 Contact information 

Street Address line 1:    
Street Address line 2:    
City:                     
State / province / parish:    Mailcode / ZIP code:
Country:                  

Enter up to three phone numbers, in order of preference
* Phone 1:      Mobile   Home   Work
  Phone 2:      Mobile   Home   Work
  Phone 3:      Mobile   Home   Work

 

 Describe your past visit(s) to Japan - if any 


 

 What Japanese language skills do you have? 

Conversation:        None   Basic   Intermediate   Fluent
Reading / writing:   None   Basic   Intermediate   Advanced

 

 

 What other connections do you have with Japan? 


 

 What do you hope to get from this adventure? 


 

 What can you share about your work? 


 

 Describe your immediate family. 


 

 What are your favorite interests or hobbies?