On-line application form


Fields marked with an are required.

    IndividualCorporation
     First Name 
    Last Name 
    Company Name
    Office Position
    Zip Code
    Address
    Address 2
    City
    state
    Country
    Telephone 
    FAX
    E-mail 
    Dons for  National Trust Activity 
    Donation amount   円
    Payment method Bank transfer only
    Date estimated of bank transfer  About  /  /  (Year/Month/Day)
    Message

    Taketomijima Regional Foundation is committed to protecting your personal data in accordance with the Privacy Policy. This donation is not eligible for a donation dedution. Please bear the burden of the bank transfer fee at your expense. Please use the bank transfer receipt as your receipt.
    Check before sending message.

    BANK Ryukyu Bank
    Branch[number] Yaeyama Branch[703]
    Account Number 1020723
    Account Name ザイ)タケトミジマチイキシゼンシサンザイダン
    一般財団法人 竹富島地域自然資産財団