Introduction To Japan - 2020
60th Anniversary Celebration
Sign up for this trip


This form serves two purposes: 1) to sign up for the trip and 2) to supply information to build your personal web page on this tripsite. Once you are successful, the webmaster will integrate your page into the site.

Heads up! Before you start filling out the form, note that it asks for a picture of you. This is optional. But if you want to include a pic, you might want to find the picture you want to use on your computer first. You can always add a picture later by emailing one to me.

Note that once you click on "Submit", you will be unable to change the information yourself. To make changes, you will need to email me at

Because we build a separate page for each traveler, we need each traveler to submit their own form: one per person, not one per family or group.

If you have any difficulties, or want to update your information, please contact me, Steve Comstock, at and I will fix the problem or make the change(s).


* - indicates a required field


 Your information 

* Your first name ("given name")
* Your last name ("family name")

  Gender (M/F):          Birthday. Year (yyyy):   Month (mm):   Day (dd):  

* Email address:  

  File name for picture:    
  (do not worry if your picture does not fit right: I will adjust it personally when I get it)

  How did you hear about this trip?  


 Trip options 

Are you planning on taking just the core trip or also include the Hiroshima pre-trip?
        Core trip   Core trip plus the Hiroshima pre-trip*   


Are you planning to add any trip extensions of your own?
        Yes*    No  


* If you select this option, we will be in touch with you to discuss details.


 Contact information 

Street Address line 1:    
Street Address line 2:    
State / province / parish:    Mailcode / ZIP code:

Enter up to three phone numbers, in order of preference
* Phone 1:      Mobile   Home   Work
  Phone 2:      Mobile   Home   Work
  Phone 3:      Mobile   Home   Work


 Describe your past visit(s) to Japan - if any 


 What Japanese language skills do you have? 

Conversation:        None   Basic   Intermediate   Fluent
Reading / writing:   None   Basic   Intermediate   Advanced



 What other connections do you have with Japan? 


 What do you hope to get from this adventure? 


 What can you share about your work? 


 Describe your immediate family. 


 What are your favorite interests or hobbies?