Tokyo American Club | Tokyo American Club

Please complete this application form in its entirety in English only.

Please input all required fields (*) to proceed to the next page.

Membership type: *

Please choose a membership type

More information about membership types here.

Category *

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Category: *

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Have you been a Tokyo American Club Member before?

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No

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Membership no:

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Resignation date:

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Click year to edit

Senior/emeritus membership transfer: parent's name:

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Senior/emeritus membership transfer: membership no:

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Personal Information

First name: *

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Middle name:

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Last name: *

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Gender: *

Female
Male

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Home address in Japan

Address Line 1: *

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Ex. Homat House #105

Address Line 2: *

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2-1-2 Azabudai

Address Line 3:

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Minato-ku

City: *

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Tokyo

Postal/Zip: *

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106-8848

Home tel:

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03-4588-0687

Cell: *

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03-4588-0687

Home fax:

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03-4588-0687

Home e-mail: *

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Nationality: *

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Date of birth: *

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English ability: *

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Years spent in the United States: *

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Years spent in other English-speaking countries: *

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Education

Highest Education Completed

Name of school: *

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School location: *

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Graduation year: *

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Degree: *

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Couple Membership

Family Membership

Please supply the information below only if you are applying for Couple/Family membership.

Spouse first name: *

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Spouse middle name:

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Spouse last name: *

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Spouse gender: *

Female
Male

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Spouse nationality: *

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Spouse date of birth: *

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Spouse e-mail: *

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Spouse cell no.: *

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03-4588-0687

Do you have children?

Yes
No

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Child first name:

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Child middle name:

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Child last name:

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Gender: *

Female
Male

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Child date of birth:

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Child nationality:

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Do you have another child?

Yes
No

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Child first name:

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Child middle name:

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Child last name:

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Gender: *

Female
Male

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Child date of birth:

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Child nationality:

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Do you have another child?

Yes
No

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Child first name:

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Child middle name:

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Child last name:

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Gender: *

Female
Male

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Child date of birth:

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Child nationality:

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Do you have another child?

Yes
No

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Child first name:

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Child middle name:

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Child last name:

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Gender: *

Female
Male

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Child date of birth:

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Child nationality:

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Do you have another child?

Yes
No

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Child first name:

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Child middle name:

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Child last name:

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Child date of birth:

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Gender: *

Female
Male

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Child nationality:

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Current Employment Information

Name of current company: *

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Position: *

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Type of business: *

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Please specify business type:

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Business address in Japan

Address Line 1: *

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Tokyo American Club Building 3F

Address Line 2: *

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1-2-1 Azabudai

Address Line 3:

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Minato-ku

City: *

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Tokyo

Postal/Zip: *

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106-8800

Business tel: *

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03-4588-0687

Business e-mail: *

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Business fax:

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03-4588-0687

Employment History

Previous Company

Company name: *

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Company location: *

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Started employment: *

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Ended employment: *

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Position: *

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Personal

Other clubs and association memberships:

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Personal Statement: *

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Provide reasons for wishing to join Tokyo American Club.

Do you or anyone covered under this application have body markings or tattoos? *

Yes
No

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The presence of a body marking or tattoo does not imply any negative or positive impact on a prospective Member’s application.

Please state name of person with tattoo: *

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How did you find out about Tokyo American Club?

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Please specify how you found out about the Club?

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Why do you want to join the Club? Please check all that apply.

Business activities

Dining outlets

Event, meeting and catering service

Family activities

Recreation and fitness facilities

Socializing and networking

Other

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Why join the club (other)

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Billing and Mailing Information

Mailing address for Club magazine: *

Home
Business
Not required

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Preferred e-mail address for communications: *

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This e-mail address will be used for all Club communications and monthly statements

Company Transfer Membership

Replacing Member Name

First name:

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Last Name:

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Membership no:

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Please fill in full membership number (ie. 00000-00)

Checklist

To complete your online application, please submit the following to the Membership Office.

Recommendation by Proposer

Recommendation by Seconder

Diners Club Card Registration Form

Passport copy for Applicant, Spouse and children if applicable

Residence card with current address

Marriage certificate

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Please download and complete the following forms:
Proposer Form
Seconder Form
Diners Club Registration Form

To complete your online application, please submit the following to the Membership Office.

Passport copy for Applicant, Spouse (if applying for Couple)

Marriage Certificate or Jyuminhyo for proof of relationship (if applying for Couple)

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Comments:

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Please let us know any other information here.

I certify that all the statements made in this application are true to the best of my knowledge and, if I am elected to the Membership, I pledge to abide by the Club Articles of Association, General Rules, House Rules and any other applicable regulations and policies.

I hereby declare that neither I nor anyone within my application have been convicted of any crimes or pled guilty or nolo contendere (no contest) to any crimes in Japan or elsewhere.

I also certify that neither I nor anyone within my application has ever had any dealings with any organized crime group or with persons related to any organized crime group.

I certify that I will keep the Club informed of any change of status regarding the information provided in this application.

I hereby give my consent to a full background check by the Club.

I agree with the above statement

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Wine & Dining

Events & Parties

Fitness & Recreation

Contact