APPLICATION FORM

Sanro

Please fill in all of the required fields (marked with *).
Please enter in normal characters on a Western-style computer.


Family name *
Middle name
First name *
Nationality *
Languages *
Occupation *
Age *
Sex * M F
Home address *


City *
State *
Country *
ZIP Code *


Phone number or mobile number *
Fax number (if applicable)
** For phone numbers, please include your country code.


Email address *
Confirm email address *


Address and phone number in Japan before coming to Eiheiji (if applicable).
Address
Phone number
Fax number


Affiliation to Soto Zen organization or place of practice
Motive for staying at Eiheiji *


Desired date to stay
*
*




** We do not accept any case of applications as below.
Sanro request within one month from today.
Applications without specified date.
A stay more than 2 nights.

** Please specify an alternate date in case your first choice is not available.
** If your schedule changes, please notify us as soon as possible.



Number of people to stay*
Male
Female
Monk
Nun
Number of rooms you request *
** Please understand that depending on the number of vacant rooms available, we may not be able to fulfill your request.
** If you make a reservation for more than ten people, please send a member list to Eiheiji by postal mail or Fax (0776-63-3631). It must include the number of applicants, and each applicant’s full name, age, sex and allergies (if any).

List of people to stay
1. Full name 
Age 
M F
2. Full name 
Age 
M F
3. Full name 
Age 
M F
4. Full name 
Age 
M F
5. Full name 
Age 
M F
6. Full name 
Age 
M F
7. Full name 
Age 
M F
8. Full name 
Age 
M F
9. Full name 
Age 
M F
10. Full name 
Age 
M F
11. Full name 
Age 
M F
12. Full name 
Age 
M F
13. Full name 
Age 
M F
14. Full name 
Age 
M F
15. Full name 
Age 
M F
16. Full name 
Age 
M F
17. Full name 
Age 
M F
18. Full name 
Age 
M F
19. Full name 
Age 
M F
20. Full name 
Age 
M F
21. Full name 
Age 
M F
22. Full name 
Age 
M F
23. Full name 
Age 
M F
24. Full name 
Age 
M F
25. Full name 
Age 
M F
26. Full name 
Age 
M F
27. Full name 
Age 
M F
28. Full name 
Age 
M F
29. Full name 
Age 
M F
30. Full name 
Age 
M F


Expected arrival time *
** Participants must arrive between 14:00 and 15:00.
If you have any food allergies, please specify










5-15 Shihi Eiheiji-cho Yoshida-gun Fukui-ken 910-1228, Japan
Tel : 0776-63-3188
/ Fax : 0776-63-3631


©2018 Daihonzan EIHEIJI .