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Supporting member registration (individual)

This is the registration page for supporting members (individuals) of the Chiba International Association.About supporting members Click here for the guidelines.

    お名前

    フリガナ

    住所

    都道府県

    市区町村番地

    それ以降

    メールアドレスE-mail address

    アドレスは半角英数で入力してください。
    携帯番号のメールアドレスでお問い合せする場合は、「受信拒否設定」を解除してください。

    確認のため再度入力してください

    電話番号Contact number in Japan

    氏名の公開について

    国際交流協会の情報誌「ふれあい」にお名前が掲載されることがあります

    情報誌ふれあいの送付

    国際交流協会の情報誌「ふれあい」がご自宅に送付されます

    ボランティア登録の有無

    賛助会費のお支払い方法

    ※振込用紙を利用できる金融機関は【千葉銀行・京葉銀行・千葉信用金庫・千葉興業銀行】です

    賛助会費のお支払い額

    ※賛助会費は2000円以上から任意で選べます。お支払額による特典の差はありません