TJCS Membership Application Form

Canada Means Business - Meet n Greet

T.G.I.F. in Nagoya

Please fill out the details of the application form below. We will review your application and contact you shortly to confirm membership payment and other details.

Thank you for your interest in the Tokai Japan Canada Society.

-TJCS Membership Committee

TJCS Membership Application

*Membership Type for which you are applying:

	Corporate Member
	Corporate Affiliate
	Individual Lifetime Member
	Individual Regular Member
	Family Membership
	Student Member

If you are applying as a "Corporate Affiliate", please indicate the Corporate Member with whom you are affilliated.
Company Name:

Personal Details

*First Name:

*Last Name:

*Title:

*Gender:

Male

Female

*Citizenship:

if "other" please indicate

*Email:

Please note that the primary method of communication is by email.
If you change your email address, be sure to let us know.

Telephone:

Mobile:

Fax:

*Home Address:
(Japan)

Ex. Urban Heights Bld. Apt. 504
Apt, etc..

Ex. Sakae 15, Naka Ku
Ward/Town

Ex. Nagoya
City

Ex. Aichi
Prefecture

Ex. 460-0008
Postal Code

*For all applicants:
Please explain why you would like to join the Tokai Japan Canada Society.

For non-Canadian applicants:
Please explain your connection
(or potential connection) to Canada.

Family Membership:
If you are applying for a "Family Membership" please list the names of the other members of your family including the ages of all children.

I declare that the above information is truthful and that I will faithfully support the purpose and goals of the TJCS.

Special Note: The TJCS reserves the right to refuse membership to any person who is judged not able to fulfill the membership eligibility requirements as determined by the Membership Committee.