Membership Application

By mail: please print this page, fill it in and send it to: Swiss-Japan Association, Case postale 169, CH-1025 St.-Sulpice, Switzerland.
By e-mail: please fill in this form electronically, and send it to contact@swiss-japan.org.

Last name: ...................................................................
Given name(s): .............................................................
Address: ......................................................................
Phone: .........................................................................
Fax: .............................................................................
E-mail: .........................................................................
Field of study: .............................................. at: .........................................................
Present occupation: ....................................................................................................
 
Stay in Japan (carried out or planned):
Company, university, institute, etc... : ..................................
Town and prefecture: ................................... from ........................ until ......................
Occupation in Japan: ...................................................................................................
 
Remarks / suggestions: ................................................................................................
...................................................................................................................................
...................................................................................................................................

I agree that my name can be communicated to companies / associations / organisations that could help the promotion of the goals of the SJA association:
yes / no: .........................................

Place and date: ..........................................................................
Signature: ..................................................................................