TRAVELER'S INFORMATION *Name *Surname *Sex MaleFemale *Date of Birth *Passport number *Passport expiration date *Nationality *Address *E-mail address House Phone number *Mobile Phone number Date of Depart (to Japan) Departure Airport (to Japan) Date of Depart (from Japan) Departure Airport (from Japan) Not compulsory. These information will be promptly reported to a doctor in the case of health problrems during your stay in Japan. Do you have any medical conditions? Disease name Please tick your blood type ABOAB ACCOMPANYING PERSON'S INFORMATION *Do you have any accompanying person? YesNo If yes, how many companions do you have? Pax 1 Name Surname Sex MaleFemale Date of Birth Passport number Passport expiration date Nationality Mobile Phone number E-mail address Pax 2 Name Surname Sex MaleFemale Date of Birth Passport number Passport expiration date Nationality Mobile Phone number E-mail address Pax 3 Name Surname Sex MaleFemale Date of Birth Passport number Passport expiration date Nationality Mobile Phone number E-mail address FOOD & DRINK Please check the box inside the square VegetarianVegan Do you have any food allergies or dietary preferences? If so, do you have any request for us? Do you have any Religious Dietary Restrictions? Please inform us if you would like to eat something particular during your stay in Japan Do you drink alcohol? YesNo What kind of alcohol do you usually drink? Please inform us if you would like to drink other drinks instead of alcohol during your trip. (for example on the ride or at your Hotel room) WaterCoca ColaCoca Cola diet or zeroPepsiPepsi diet or zeroJapanese TeaSports drinkCanada dryOrange JuiceGrape JuiceCoffee blackCoffee with sugarCafé au laitCafé au lait with sugarEnglish teaEnglish tea with sugar Others SIGHTSEEING & ACTIVITIES Please inform us about the places you would like to visit and also if you want to try unique Japanese culture firsthand experiences Sightseeing Japanese culture firsthand experiences CELEBRATIONS Please tell us you want to go, what you want to do, what you want to eat in your free time Do you have any celebrations during your stay? BirthdayAnniversaryOthers When (yyyy/mm/dd) ACCOMMODATION Do you have any preferred accommodation during your stay in Japan? If yes, please write down the name of two Hotel/Ryokan (Japaneases Inns) where you would like to stay. Tokyo Hakone Aomori Takayama Kyoto Nara Osaka Fukuoka Okinawa Island Ishigaki Gifu Hokkaido Island Please let us know if you have any other cities or any other types of accommodation where you would like to stay
