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Prayer Application

Prayer application

Prayer matters ※Required
Prayer ceremony fee ※Required
Company Name
Only when applying as a company
Furigana
Name ※Required
Example: Taro Yamada
Furigana ※Required
Example) Taro Yamada
Sex
Date of Birth ※Required
Year Month Sun 
age ※Required
age
Address ※Required
Postal Code 
Street number, shop name, etc. ※Required
Phone ※Required
Example) 012-345-6789 * Mobile phones are available
FAX
Example: 012-345-6789
E-mail address ※Required


* Re-enter for confirmation
Remarks
If the prayer item is set to "Other" Please enter the prayer item here.
Where to take the exam and the date of the exam. Please also enter the travel destination, departure date, return date, etc. for travel safety here.
Please enter your name and address here only if you want to send the Shinsen to a different destination.
Destination name
Address
Postal Code 
Phone
Araki Jinja
〒612-0805
12-3, Fukakusakaidoguchicho, Fushimi-ku, Kyoto-shi, Kyoto
TEL.075-643-0651
FAX: 075-644-0170
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