Application Form

Thank you for choosing us.
Your passport information is required to fill in this application form. Please prepare your passport before starting.
Please also send a photocopy of your passport by email or fax later.

Your Information

Title　Required	Mr. Ms. Prof. Dr.
Name in Alphabet　Required As shown in your passport	Given:Required Middle: Family:Required
Name in Chinese Character
Gender　Required	Male Female
Date of Birth　Required
Nationality　Required
Current Address　Required	Address: Zip Cord:　〒 -
Phone (Home)　Required	- -
FAX (Home)	- -
Mobile Phone	- -
Affiliation　Required
Department　Required
Job Title　Required
Business Address　Required	Address: Zip Code:　〒 -
Phone (Business)　Required	- -
FAX (Business)	- -
Email　Required

Emergency Contact in Japan

Please provide contact information in Japan in case of emergency during your trip.

Emergency Contact in Japan　Required	Name: Relationship: Phone: - -

Passport

Provide your passport information below, and also send the copy of your passport by FAX, Email attachment, or postal mail.

Passport Number
Date of Issue
Date of Expiry
Issuing Authority

Special Request

Frequent Flyer Program	Carrier: Number:
Seat Preference	Window Aisle
Others

International Travel Insurance

We strongly recommend that you purchase travel insurance to cover all aspects of your trip.

International Travel Insurance　Required	I would like to purchase insurance from Art Tourist (Please wait for an application form) I need more information about insurance (Please access to the URLs in the confirmation email that you'll receive later) I won't purchase insurance from Art Tourist. To those who choose "I won't purchase insurance from Art Tourist," why?:

Privacy Policy

Privacy Policy　Required	I Agree to the Privacy Policy Privacy Policy (open a new window) *All personal information you supply is encrypted via Secure Socket Layer (SSL) technology on our website.