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Application form page (from October to March)

Application form (Maekawa-so) from October to March

Plan name ※required
Representative full name ※required
Furigana ※required
The date of birth ※required
/ /   
Sex ※required
Phone number ※required
(Half-width number)

※Please input cell phone number as the emergency contact information. (I do not need hyphen input)
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 January to March) ※required

※An exclusion day: 12/28-1/5
※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

※①Ship, 1⃣ - 2⃣ high-speed in -④ in Jetfoil, ⑴ - ⑶ are ferries
※A Jetfoil, the high-speed ship is adult 3,000 yen (dwarf 1,500 yen) up per one way one
The port of upper Goto start on a voyage time (surface mail) ※required

※①Ship, 1⃣ - 2⃣ high-speed in -④ in Jetfoil, ⑴ - ⑶ are ferries
※A Jetfoil, the high-speed ship is adult 3,000 yen (dwarf 1,500 yen) up per one way one
Remarks (if there is hope of the assigning rooms, please fill this 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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