Request for Issuance of a Letter of Introduction to an Affiliated Club

(This form is only to apply for a Letter of Introduction. Reservation requests should be sent directly to the relevant club.)

TO: Membership Office, International House of Japan

FROM: Membership No.:
      Name: (required)
      E-mail address: (required)

Please issue a Letter of Introduction as below and send it to the club with cc to me.

1. Name of the Affiliated Club

(Please choose from the pulldown list.)

2. Details of Accommodation Reservation

Check-in date: ,

Check-out date: ,

Guest Name: SELF

Name of Accompanying Person:

Confirmation Number: 

3. Details of Restaurant Reservation
(for Cosmos Club, Cornell Club, and Reform Club only)

Date: , / Time: :

Reservation Name: SELF

Name of Accompanying Person:

Remarks:

Example: during the stay from month/day to month/day

 Check here to confirm the above information before clicking the Send button.