Your Profile *=required
(If your family members are attending with you, please fill out the application for each member of your family.)
*Last Name
*First Name
*Gender:
Male
Female
*Are you attending with your spouse :
Yes
No
*Date of Birth :
ex.10/13/67
*Your Current Residing Country :
（Please write down the name of the country where you live right before ec. If you are moving after ec, please answer the question below.）
Your Residing Country AFTER ec04 :
（Please write down the name of the country where you live AFTER ec.）
Your E-mail
*E-mail
To confirm, please type in your e-mail address above
*
Your Contact Information
（If you live or have an address in Japan, please fill out the section in the following called "Address in Japan". We might need to get in touch with you before the conference, so please make sure to write down the contact information that we can reach you.）
Street
City
State
Zip
Country
Tel
Fax
Cell
Address in Japan (if you have or it differs from the above)
Zip
Prefecture
City
Street
Apartment, Building Name, etc.
Tel
Fax
Cell
About yourself
Occupation:
Student
Working
Ministry
Other
Are you Christian?
Yes
No
Are you a JCFN member?
Yes
No
Do you need scholarship?
Yes
No
Points to be checked for the conference
-Do you need to be picked up?
Yes
No
-How do you plan to come?
Car
Plane
We will send you a receipt letter and more detailed traveling information after receiving your application form.
*-Preferred Language
Japanese
English
Please bring your own FM radio for English-Japanese translation.
- I would like to help in these areas;
Small group leader
Translator
Photographer
Camcoder
Book table
Registration
Childcare
Transportation
Sound
Refreshment
Facility
Workshop Moderator
Powerpoint
Worship team (Instrument:
)
Prayer
Any area needed
Other
Any special needs/help/requests (including room arrangement)?
*Payment Method
Credit Card
Check, Money Order, or Postal Transfer
Please read "Acknowledgment and Release of Liability". Without agreeing with this, you cannot be registered for this conference!
*
I have read, understood, and agreed with "Acknowledgment and Release of Liability.
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