Application Form for Membership

Application for Individual Members and Term Memberscan be sent either by post mail, by e-mail or by using the online form below. The application should have recommendations from two current House Members.When using this online form, please ask those two members to submit their recommendation statements to member(at)i-house.or.jp (please replace (at) with @), from their e-mail addresses registered with the I-House.

The Membership Department will revert to you within two weeks after the application and recommendation statements are duly received.

    Please read our privacy policy and understand that the personal information included in your inquiry will be handled with care in accordance with this policy.

    E-mail address for contact (mandatory)

    Category of contact e-mail address
    HomeOffice

    Back-up e-mail address

    Category of back-up e-mail address
    HomeOfficeNot to register

    Last name (mandatory)

    First name (mandatory)

    Middle name

    Last name (Japanese)

    First name (Japanese)

    Gender (mandatory)
    MaleFemaleOther

    Title (mandatory)
    Mr.Mrs.MissMs.Dr.Prof.Mx.

    Date of birth (MM/DD/YYYY) (mandatory)

    Nationality (mandatory)

    Name of spouse/partner (Last Name, First Name, Middle Name)

    Contact information

    Home address

    Home phone

    Private mobile phone

    Home fax

    Affiliation
     

    Job title

    Office address
     

    Office phone

    Office mobile phone

    Office fax

    Billing address (mandatory)
    HomeOffice

    Mailing address (mandatory)
    HomeOffice

    Monthly E-News to be sent to: (mandatory)
    HomeOffice

    Membership Category (mandatory)
    Resident in JapanNon-resident in JapanTerm MemberLifetime Member

    Initial donation Amount (Please choose one when selecting "Resident in Japan" or "Non-resident in Japan")

    Resident in Japan

    Non-resident in Japan

    Name if one of your family/relatives is a member of I-House and relationship to the applicant

    Specialty

    Education

    Professional Experience, Associations and Accomplishments, etc.

    Reason for applying for membership, including any expectations regarding the I-House and its activities.(mandatory)

    Name of member who support your application (Primary)
    (mandatory)

    Name of member who support your application (Secondary)
    (mandatory)

    I hereby apply for membership in International House of Japan, and agree to endorse its aims and activities and to abide by its membership bylaws. Furthermore, I have read and understood the contents of its privacy policy .

    This website uses reCAPTCHA, a free security service provided by Google, to protect our contact forms from spam and abuse. If you are experiencing technical difficulties, please contact us by phone.

    Inquiries

    Membership Department
    International House of Japan
    5-11-16 Roppongi, Minato-ku, Tokyo 106-0032
    TEL: 81-3-3470-9115 (Mon.-Fri., 9:00 am-5:00 pm)
    FAX: 81-3-3470-3170
    E-mail: member(at)i-house.or.jp (please replace (at) with @)