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日本とハワイを繋ぐ国際結婚＆グローバル婚活サポート

アロハラニエージェンシハワイオフィシャルサイト

Home
- Japanese
About
- Go Aloha
Membership
Events
Ohana Services
Concierge Services
Privacy Policy
- Terms of Service
- Release of Liability
Contact

Home
- Japanese
About
- Go Aloha
Membership
Events
Ohana Services
Concierge Services
Privacy Policy
- Terms of Service
- Release of Liability
Contact

◇ Membership Registration Form ◇

【会員ご登録フォーム】

Please fill out in English * Requirement fields

英語でご記入下さい。*印は必須項目です

First Name / 名*

Last Name / 姓*

Contact Number / お電話番号*

LINE ID*

Current Address / 現住所*

Work Address & Phone / 仕事先住所＆電話*

Email Address / Eメール

DOB / 生年月日*

Age / 年齢*

Gender / 性別*

Birth Place

Current City / お住まいの県／都市名*

Height / 身長*

Weight / 体重*

Nationality / 国籍*

Race / 人種*

Language(s) / 言語*

Marriage Status / 結婚歴*

Never Married / 未婚Divorced /　離婚歴有りWidow / 未亡人

- If divorced, how many times and when? / 離婚歴のある方は何回？いつ頃？

- If widow, when you became a widow? / 未亡人の方はいつ未亡人になりましたか？

Education Level / 最終学歴*

School Name / 学校名*

Profession & Title / ご職業＆役職*

Annual Income / 年収*

Religion / 宗教*

NoneChristianBuddhistShintoMormonOther

- If other, please explain

Any Children? How many? How old? / お子さんはいますか？何人？年齢は？*

Any pets? How many? What kind? / ペットはいますか？何匹？ペットの種類は？*

If you live with anyone, please explain / 同居している方はご説明下さい*

Do you want to have children? How many? / お子さんは欲しいですか？　何人欲しいですか？*

Hobbies / 趣味*

Personality / 性格*

Health Condition / 健康状態*

- If you have any medical condition, please explain / 持病がある場合はご説明下さい。

Do you smoke? / 喫煙は？*

NoneSometimeseverydayHeavy

Do you drink? / お酒は？*

NoneSometimeseverydayHeavy

Favorite Food / 好きな食べ物は？*

Preference age range for your partner / パートナーのご希望年齢は？*

Preference type for your partner / パートナーに対する好みのタイプ*

Please list the number in order which is most important for you in relationship: 1. Words of Affirmation 2. Quality Time 3. Receiving Gift 4. Acts of Services 5. Physical Touch / 貴方が交際で最も大切だと思う項目を順に並べてください。①肯定的な言葉　②クオリティ・タイム　③贈り物　④サービス行為　⑤身体的なタッチ*

Favorite animal and least favorite animal / 好きな動物と嫌いな動物*

Favorite Movies? / 好きな映画は？*

Favorite Music? / 好きな音楽は？*

Reasons for seeking International marriage / 国際結婚を希望する理由*

How did you know about us? / ALA ハワイをどちらでお知りになられましたか？*

WebsiteNewspaperMagazineFacebookTwitterInstagramFriend

- Please provide your friend's name if you answer friend above / 上記の質問でご友人を選ばれた場合、ご友人のお名前をお知らせください

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* ALA Hawaii donates a portion of its profits to Make A Wish Hawaii, Salvation Army, Shelter Hawaii, Save the Children, Polaris Project etc.

* ALA ハワイは収益の一部をメイクアウィッシュハワイ、サルベーションアーミー、シェルターハワイ、セーブ・ザ・チルドレン等に寄付させて頂いてます。

© 2014 Aloha Lani Agenci Hawaii. All Rights Reserved.

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