Visitor Application Form

Please fill out the form below and click "submit".

Full name*
Nationality*
Gender*
Date of birth*
Occupation
E-mail*
Phone Number*
Address*
Date and time of arrival*
Transportation*
Date and time of departure*
Level of your Japanese fluency
Do you have any allergies to food?*
- Yes
- No
If you responded "Yes" to the above, please provide a brief description.
For example: I am allergic to eggs, I am a vegan, etc.
How did you find out about Konohana Family?*
Why do you like to visit us?*
What do you hope to take with you when you leave?*
If you would like to join the following activities, please check.
- Farming or cooking experience (free of charge)
- Presentation on our community (540 yen/person if more than 5 guests participate. Otherwise, 2,700 yen of the whole presentation fee will be shared with the number of requesting guests.)
- Guide tour including our rice and vegetable fields, green houses and chicken house (540 yen)