Republicans Abroad Japan

E-mail:rajapan@gol.com

Membership Application

  I am a U.S. citizen and wish to join Republicans Abroad Japan (RAJ); I understand that RAJ dues are JPY 5,000 per person per year.

  I am NOT a U.S. citizen, but wish to join Friends of Republicans Abroad Japan (FRAJ); I understand that FRAJ dues are JPY 5,000 per person per year and will be used only in Japan to support RAJ.

Annual membership may be paid by bank transfer to the account of Republicans Abroad Japan, Citibank N.A., Hiroo Branch, Yen Savings Account No. 5811066; or by registered mail to Republicans Abroad Japan at the address shown above. Sorry, no credit cards accepted.

Name:

Home address:

City/Postal code:

Home phone:     Home Fax:

Work phone:     Work Fax: 

E-mail:             ( Home / Office)

Nationality:

If US citizen, last U.S. residence:
City: State: County:

I would like to participate/assist in the following activities:

      Voter registration                Programs/Special events      Membership

      Communications/Publicity     Fundraising

      Other (please specify)