Membership form | Japan African Union

Surname*

Middle name

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Your email*

Date of birth*

Sex*

Male

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Occupation*

Residential address in Japan

Mobile phone number

Marital status*

Married

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Others

Nationality*

Next of kin in Japan*

Next of kin in Japan other details*

Next of kin in country of origin*

Next of kin in country of origin other details*

Email address

Tel: 03-3836-9061

Mobile: +819088521490