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The first half of 2012 blue ize application form

Maekawa-so plan (blue at the first half of 2024)

Plan name ※required
Representative full name ※required
Furigana ※required
The date of birth ※required
/ /   
Sex ※required
Phone number ※required

※Please input cell phone number as the emergency contact information.
E-mail address ※required


※A lot of cases which an email does not reach to an address of iCloud are confirmed. I am sorry to trouble you, but I would appreciate your registering an address except iCloud as much as possible.
※There is the possibility divided in two by ha junk email to Gmail. Please confirm it to a junk email box.
Address ※required
 
The number of participants (adult) ※required

※I become an adult from junior high student or more.
The number of participants (primary schoolchild)
The number of participants (infant)

※When a seat, a meal is unnecessary, I am free of charge.
The number of men ※required

※Please choose the number of men who are older than a primary schoolchild.
The number of women ※required

※Please choose the number of women who are older than a primary schoolchild.
The departure date (from April to June) ※required

※I take it off than a choice on no vacancies day.
※Please note that you may not take it depending on the space situation on the selectable day either.
The departure date (from July to September) ※required

※An exclusion day: 7/20-8/31
※I take it off than a choice on no vacancies day.
※Please note that you may not take it depending on the space situation even if you can choose it.
The Nagasaki Port start on a voyage time (surface mail) ※required

※Ship high-speed as for the Narao Port arr. as for Jetfoil, the Arikawa Port arr.
The port of upper Goto start on a voyage time (surface mail) ※required

※Ship high-speed as for the Narao Port dep. as for Jetfoil, the Arikawa Port dep.
Remarks (if there is food allergy, please fill it out)
Please input to one person about the companion.
Companion 1: Full name ※required
Companion 1: Furigana ※required
Companion 1: The date of birth ※required
/ /   
Companion 1: Sex ※required
Kyushu Syosen
〒850-0035
16-12, Motofunamachi, Nagasaki-shi, Nagasaki
TEL.0570-017510
1.Passenger regular line business
2.Harbor express service
3.Transportation business
4.Travel agency
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