On-line membership Application

Salutation

Last Name

First Name

Address

Phone number (Home)

Phone number (mobile)

Occupation

Hobbies and Interest

Would you like to include your family member(s) in the membership?

Yes

Who would you like to include ? (name and Relationship)

Where did you hear about JLA ?

Please tick the boxes of your interests

Cafe

Origami

Cooking Class

Japanese Sweets Class

Sake Club

Sumie

Japanese Calligrapy

Ikebana

Walking

Othes *

* Other (Please describe)

Cafe

Origami

Cooking Class

Japanese Sweets Class

Sake Club

Sumie

Japanese Calligrapy

Ikebana

Walking

Please tell us what you would expect from JLA

Questions

Note: Please fill out the fields marked with an asterisk.

The informations given in this application will not be used for anything unrelated to JLA's activities in addition, they will not be given to any third party without your consent.

JLAへのお問い合わせはこちらのメールアドレスまで。

Feel free to contact us on:

mail@jlaluxembourg.org

¹ Applies to shipping within Luxembourg. Information about shipping policies for other countries can be found here: Payment and Delivery Information

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