Application for a Membership in New Senri's Lounge

Application Form for a Membership in New Senri's Lounge

This is a form for the bank payment dealing with a foreign exchange.
Firstly, please read "CAUTION" and if you can agree them,
Click a "OK" button after writing the content of all items.

Your Name:	<- Your First Name / Last Name
E-Mail:	<- Alphanumeric Only
	Please be careful to write your e-mail address exactly. You can get your e-mail address at Hotmail, if you don't have it.
Postal Code:	<- Alphanumeric Only
Your Address:
Your Country:
Select a Members Ticket:

Your Comments (If necessary)

CAUTION

If you bought a Members Ticket, we will inform you of an ID & Password to enter into the Member's Room in New Senri's Lounge.

If you bought an Ultimate Members Ticket, we will inform you of an ID & Password to enter into the Ultimate Member's Room in New SENRI'S LOUNGE.

If you bought a Service Pack Ticket, we will inform you of both ID & Password to enter into the Member's Room and Ultimate Member's Room in New Senri's Lounge.

(1) Both members tickets have the expiration date for 6 months.
(2) As for ID & Password, you can specify it to me at the comments field above.
(3) One pair with an ID & Password is applied to only one person.
(4) It will may cancel your ID in case of abusing an ID & Password by you.
(5) I cannot repay you when you paid once even if you have any reason.