Japan-America Society of Indiana
2010 Annual Dinner


Wednesday, December 1, 2010
Indiana Roof Ballroom, Indianapolis

Registration Deadline: Tuesday, November 23, 2010.  No refunds after this date.

Contact Information

Please List Guest Names:

Registration Fees

* Patrons' Reception (from 5:30 pm to 6:30 pm) limited to Sponsor and Patron guests.

* パトロン”でお申込みいただいた方のみ、5:30-6:30pmまでのパトロン･レセプションにご参加いただけます。その他の皆様は、6:30pm以降に会場にお出かけください。

Patron Corporate Table of 8 (8人掛けパトロン･コーポレート・テーブル)     $1800
Patron Individual (パトロン・個人)                                                                       $200
Corporate Table of 8 (コーポレート・テーブル)                                                 $800
Individual (個人)                                                                                                     $80

Payment Method

Mail Check
Make check payable and remit to:　(下記住所まで、小切手をお送りください):　
Japan-America Society of Indiana, Inc
Union Station
39 West Jackson Place, Suite 50
Indianapolis, IN 46225
Online Credit Card　
If you celect to pay by credit card you will be taken to a form immediately after this form has been successfully submitted. 　
(下記、お申込みボタンをクリックした後、オンラインでのお支払い画面に進みます)
Send me an invoice
We will send you an invoice soon. 　
(ご請求書をお送りさせていただきます。)