Membership Application

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 *
Please choose a category
Category: *
Please choose a category
Have you been a Tokyo American Club Member before?
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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: *
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Home address in Japan
Address Line 1: *
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Ex. Homat House #105
Address Line 2: *
Please input data to proceed
2-1-2 Azabudai
City (Ward):
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Minato-ku
Prefecture: *
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Tokyo
Postal/Zip: *
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Format should be: XXX-XXXX
106-8848
Home tel:
Please include phone number with hyphens.
03-4588-0687
Cell: *
Please include phone number with hyphens.
03-4588-0687
Home fax:
Please include fax number with hyphens.
03-4588-0687
Home e-mail: *
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Nationality: *
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Date of birth: *
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Click year to edit
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: *
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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.: *
Please include phone number with hyphens.
03-4588-0687
Do you have children?
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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: *
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Child date of birth:
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Child nationality:
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Do you have another child?
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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: *
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Child date of birth:
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Child nationality:
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Do you have another child?
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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: *
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Child date of birth:
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Child nationality:
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Do you have another child?
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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: *
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Child date of birth:
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Child nationality:
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Do you have another child?
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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: *
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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: *
Please input data to proceed
Tokyo American Club Building 3F
Address Line 2:
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1-2-1 Azabudai
City (Ward):
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Minato-ku
Prefecture: *
Please input data to proceed
Tokyo
Postal/Zip: *
Please input data to proceed
Format should be: XXX-XXXX
106-8800
Business tel: *
Please include phone number with hyphens.
03-4588-0687
Business e-mail: *
Please input data to proceed
Business fax:
Please include fax number with hyphens.
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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Do you or anyone covered under this application have body markings or tattoos? *
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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: *
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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
Personal

Background
Explain how your professional and educational background aligns with those of the membership.

*
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English language ability
If English is not your native tongue, please detail your English-speaking ability.

*
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Financial Status
Confirm your ability to meet your financial obligations as a Member.

*
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Characteristics and Club values
Explain how your personal qualities align with the values and culture of the Club.

*
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Interests
Highlight any interests you have and explain how you intend to immerse yourself in the Club community.

*
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Motivation
Share why you want to join Tokyo American Club.

*
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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 Diners Club card application:
Diners Club Registration Form You will receive links to share with your Proposer and Seconder in the application confirmation email.

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.


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Photo Upload

Please submit a forward-facing color photograph (.jpg) with plain background taken in the last 6 months for Club ID.

Upload Your Photo: *
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Upload Your Spouse Photo:
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Upload child (1) photo:
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Upload child (2) photo:
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Upload child (3) photo:
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Upload child (4) photo:
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Upload child (5) photo:
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Upload copy of passport:
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Upload copy of spouse passport:
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Upload Marriage Certificate or Jyuminhyo:
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Enter the letters you see: * Enter the letters you see:
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