Japan Custom Group Travel Inquiry Form

Title Mr Mrs Ms Miss Title

First Name *

Middle Name

Last Name *

Yes, I am a travel agency

Street Address

Apt/Suite/Bldg

City

State/Region

Zip/Postal code

Country

Email address *

Re-confirm E-mail address *

Phone Number

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 Adults (12 & up)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 Children with bed (3-11)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 Children with no bed (3-7)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 Infant/Toddler (0-2)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Single Room(s)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Twin Room(s)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Double Room(s)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Triple Room(s)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Quad Room(s)

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Length of trip (in nights)

0 1 2 3 4 5 6 7 Flexibility (in nights)

Departure Date

Return Date

Select One Vacation Business Student Group Family and Class Reunions Senior Group Special Interest Group Religious Group Fundraising Group Other

Select One No breakfast Breakfast included in the hotel Breakfasts

Select One No lunch Some lunches All lunches Lunches

Select One No dinner Some dinners All dinners Dinners