Entry Form
Select the reason for your email
(Required)
Inquiries
Comments
Select if you would like the city to respond:
(Required)
Response expected
Response not required
Subject
(Required)
Text
(Required)
Family Name
Given Name
Email Address
(Required)
Telephone Number
Postal Code
District Name
Select
Kawasaki-Ku
Saiwai-Ku
Nakawara-Ku
Takatsu-Ku
Miyamae-Ku
Tama-Ku
Asao-Ku
Outside city
Street Name
(full street address if nondomestic)
Street Address
Building Name
Gender
Select
male
female
otherwise
Age
Select
under 10
10-19
20-29
30-39
40-49
50-59
60-69
70-79
Over 80
Occupation
Select
Self-employed
Employed (full-time)
Employed (part-time)
Housewife / Househusband
Student
Unemployed
Other
→Back to previous page