Thank you for inquiring about JCFN. We are providing you with a detailed application form so that we can have your name, church and other important information on our data base. Would you please fill it out and send it back to us? Thank you.

* = Required Field

Address Oversea (if it is different from the above):

Phone:
Fax:
E-mail:

Would you like to be in the JCFN Directory
Yes No

What is your motivation in joining JCFN?

Who introduced you to JCFN?

How, when, and where did you become a Christian?

Occupation
School/Major?

Occupation/Company Name

If you are living outside of Japan, are you a resident of that country?
Yes No

If no, when do you plan to go back to Japan permanently?

Send me JCFN Newsletter in Japanese
Send me JCFN Newsletter in English
Send me information on Prayer Warrior
Need follow-up
Date of moving Address/Location
Send me information on Follow-up Partner
Send me information on Network Partner
Send me information on JCFN regional meetings
Send me information on conferences
I will support JCFN financially

When are you returning or did you return Japan permanently?
Year Month

How long have you stayed in oversea? year(s)

Do you have a church in Japan?
Yes No

Denomination:
Name of the Church:
Are you a member?	Yes No
Street address:
City:
State or Province:
Zip or Postal Code:
Phone:
Pastor's name:
Nearest train line:
Nearest train station:
Sunday service time:

Other weekly meetings scheduled:

Do you wish to obtain information on churches/fellowships in Japan?
Yes No

Is there any church, Bible study group or fellowship you attend in a foreign country?
Yes No

Name of the church:
Are you a member?	Yes No
Street address:
City:
State or Province:
Zip or Postal Code:
Phone:
Pastor's name:
Sunday service time:

Other weekly meetings schedule:

Is this mainly for Japanese speaking people? Yes No