REGISTRATION FORM

Please complete and return this registration form with check or credit card information. Make checks payable to SHOWA BOSTON and mail to:
Finance Department, Att. Strat
Showa Boston
420 Pond Street, Boston, MA 02130
To register by FAX, complete form including credit card information and fax it to 617-522-8155.

Name:___________________________________________________

Address:________________________________________________

City:_____________________________ State:_______ Zip:___________

Home Phone: __________________________________

Work Phone: __________________________________

E-mail:____________________________________________
Please fill in the level of class and the day.

1st Choice
Level of Class:________________ Day:_________________
2nd Choice
Level of Class:________________ Day:_________________
CREDIT CARD INFORMATION
__Visa __Master Exp. Date:_________________
Card #_____________________________________________
Please tell us how you found Showa /Japan Society Japanese Program:
___ Internet search engines      ___ Showa Boston website
___ Japan Society website      ___ Word of mouth
___ Flyers         ___ Other __________________________
Thank you!