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Member registration (input page)

name Surname   Name 
Country
Prefectures
Postal code

   

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City or county
City name (eg: Karasuma-ku, Kyoto City)
Street name / street / building name
Street · building name (eg 1-3-5)
phone number     
mail address

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Desired password

Hanko alphanumeric characters 4 to 50 letters please. (Symbol not allowed)

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