Japan-America Society of Indiana
Annual Dinner "Ganbaranakucha!"

Wednesday, November 11th, 2009
Indiana Roof Ballroom, Indianapolis

Registration Deadline: Friday, November 6th.  No refunds after this date.

Contact Information (代表者のご連絡先)

Corporate Table Guests' Names (List Table Captain First)
Or Additional Individual Guests' Names:

Registration Fees


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 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.
Send me an invoice
We will send you an invoice soon.