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The 9th Fukushima Vocal Ensemble Competition 2016
REGISTRATION FORM 4 – Payment
Category / Category I / Category II / Category III－1 / Category III－2
Choir Name
Application for Travel Package
Singers(2-16)
Accompanist(s)
Conductor(s)
Up to 18 persons / Economy Twin / JPY 6,000 / x / person(s) / = / JPY
Deluxe Twin / JPY 9,000 / x / person(s) / = / JPY
Deluxe Single / JPY12,000 / x / person(s) / = / JPY
Others / Economy Twin / JPY41,000 / x / person(s) / = / JPY
Deluxe Twin / JPY44,000 / x / person(s) / = / JPY
Deluxe Single / JPY50,000 / x / person(s) / = / JPY
Total / = / JPY
If you have foods cannot eat due to allergies, personal beliefs or religious reasons, please indicate here.
Optional Plan – Additional Stay
from / Mar. / to / Mar.

A. Additional Stay in Fukushima

Economy Twin / JPY 9,000 / x / days / x / person(s) / = / JPY
Deluxe Twin / JPY10,000 / x / days / x / person(s) / = / JPY
Deluxe Single / JPY11,000 / x / days / x / person(s) / = / JPY
from / Mar. / to / Mar.

B. Additional Stay in Narita

Economy Twin / JPY 8,000 / x / days / x / person(s) / = / JPY
Economy Single / JPY10,000 / x / days / x / person(s) / = / JPY
from / Mar. / to / Mar.

C. Additional Stay in Haneda

Economy Twin / JPY12,000 / x / days / x / person(s) / = / JPY
Economy Single / JPY15,000 / x / days / x / person(s) / = / JPY
Total / = / JPY
Optional Plan – Transportation

A. From Fukushima Airport

Singers(2-16)
Accompanist(s)
Conductor(s) / One-way / JPY 2,000 / x / person(s) / = / JPY
Return / JPY 3,000 / x / person(s) / = / JPY
Others / One-way / JPY 3,000 / x / person(s) / = / JPY
Return / JPY 3,000 / x / person(s) / = / JPY
Total / = / JPY

B. From Narita International Airport

Airport Bus (Narita – Fukushima St.) / JPY 5,650 / x / person(s) / x / way(s)
Train (Narita – Ueno St. – Fukushima St.) / JPY11,840 / x / person(s) / x / way(s)
Chartered Bus / 【Large (Max 50 people)】 / JPY200,000 / x / bus(es) / x / way(s)
【Medium (Max 30 people)】 / JPY190,000 / x / bus(es) / x / way(s)
【Small (Max 20 people)】 / JPY180,000 / x / bus(es) / x / way(s)
Total = / JPY

C. From Haneda International Airport

Train (Haneda – Ueno St. – Fukushima St.) / JPY 9,360 / x / person(s) / x / way(s)
Chartered Bus / 【Large (Max 50 people)】 / JPY200,000 / x / bus(es) / x / way(s)
【Medium (Max 30 people)】 / JPY190,000 / x / bus(es) / x / way(s)
【Small (Max 20 people)】 / JPY180,000 / x / bus(es) / x / way(s)
Total = / JPY
Optional Plan – Sightseeing Tour
Sightseeing Tour / JPY 9,000 / x / person(s) / = / JPY

Date Month

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Payment Method

We pay the Participation fee JPY20,000 and travel fees by the following method.

(Please put ü mark in the chosen boxes.)

Credit Card (VISA, Master, American Express, Diners, JCB)
Name on Card / Card Number

Month Year

Expiration Date / 2 / 0

*Billing Address

same as the contact person’s address in Registration I (No need to fill in the below)

フォームの始まり

First Name / Last Name

Address Line1: Street address, P.O.box, c/o

Address Line2: Apartment, suite, unit, building, floor, etc.

City / State/Province/Region
ZIP / Country
Phone / Country code / Area code / Number
Bank Transfer

Bank Name Toho Bank Central Branch

Bank Code 0126 BIC/SWIFT: TOHOJPJT

Address of Bank 3-25 Omachi Fukushima city, Fukushima prefecture, 960-8041 Japan

Beneficiary Yukihiro Chiba, President of JTB Tohoku inc.

Address of Beneficiary same as Address of Bank

Branch/Account Number 101-11318

Bank Account

Please state the bank account for transferring the award of the Grand Champion Competition.

Bank Name
Bank Code
BIC
SWIFT
Address of Bank
Beneficiary
Address of Beneficiary
Branch
Account Number