Dr. Mr. Mrs. Ms. ________________________ Birthday ___________
(Please advise name as shown on your passport)
 Passport Number _________________________
 Expiration Date _______________
 Occupation  _____________________________

Dr. Mr. Mrs. Ms. _________________________Birthday ___________
(Please advise name as shown on your passport)
 Passport Number _________________________
 Expiration Date _______________
 Occupation  _____________________________

Home Address________________________________
City_____________________State______Zip_______

Preferred Mailing Address ______________________
City ____________________ State ____  Zip _______
(Final documents are sent by UPS, advise most convenient
delivery address for this.)

Home phone number: ____________________________ 
Business phone: _________________________________
Fax number: ____________________________________

 Email address: ____________________________________   

Japan Airline or American Mileage Numbers: ____________

Airline seat preference:  _____________________
(seats are on request basis)

 Hotel room preference:  Smoking _______ 
Non smoking _______  Other special requests if any____________________________________________________

Please advise if there are any special dietary, medical or physical problems of which we should be aware of ______________________________________________

Please advise if you wish to extend your stay in Japan, on
your own.  Destination and dates: ______________________________________________

Please provide name, relation and phone number of person
to contact in case of emergency: ______________________________________________
PLEASE SEND COMPLETED APPLICATION AND DEPOSIT
OF $500.00 PER PERSON, ALONG WITH A PHOTO COPY
OF YOUR VALID PASSPORT TO:

 YAMATO TRAVEL BUREAU®
 (CST # 1019309-10)
 250 East First Street,  Suite 1112
 Los Angeles, CA  90012

 Phone:  (213) 680-0333 or (800) 334-4YTB (outside of local area)
 Fax:  (213) 680-2825
 Email:  groups@yamatotravel.com

 Final payment is due by