How to become a member of the Cornell Club of Japan

1. You may become a member of the Cornell Club of Japan if you are a graduate of Cornell or have otherwise been formally associated with Cornell--for example, by having been a visiting professor, or researcher.

2. Fill out the application form.

3. Pay your membership dues. New members pay Y4,000 for 1 year or Y10,000 for 3 years. Please transfer your dues to the Club's account at SMBC Trust Bank. Bank account information is here.



 
October 25, 2020

(Members may use this form to submit directory info corrections).
Except where noted, please enter all information in English.


This is a:
New Application for Membership.
Correction or change of information already on file with the club.
(You only need to enter your name, school and the new info).

Personal



Last Name (Tanaka)
First Name (Taro)
Last Name Used at
Cornell, if different.

(Maiden Name, etc.)

 Kanji Name
(non-Japanese:
katakana)

Cornell ID
(If known)


Male Female
Cornell School 1

Year 1
Degree 1

Major 1

Cornell School 2

Year 2
Degree 2
Major 2


Residence


Care of
Your Residence Address
will look like this:
Bldg (Lions Palace 407)
Street (1-2-3 Denenchofu)

Ku
other-Ku (if your Ku is not on the list at left, please enter it here)
Shi (or foreign city)
Shi (if your Shi is not on the list at left, please enter it here)

Ken

Postal Code

Tel Area Code
Tel Number

Country (Leave empty for Japan)

Fax Area Code

Fax Number
 
Personal e-mail


Work


If you do not wish to submit work information please check this box

Company Name
Your work Address will look like this:
 Company Kanji
Your title or position (Vice President)

Division on Dept. (Marketing Dept.)
Tel Area Code
Tel Number

Care of
 
Fax Area Code
Fax Number

Bldg (Kasumigaseki Bldg., 25F)
Work e-mail

Street
(1-2-3 Kasumigaseki)
 

Ku

other-Ku
(if your Ku is not on the list at left, please enter it here)
Shi (or foreign city)

Shi
(if your Shi is not on the list at left, please enter it here)

Ken

Postal Code

Country (Leave empty for Japan)

 

Preferences




Send postal mail to my

Residence
Work
Committee Interest
* CAAAN is the Cornell Alumni Ambassadors Abroad Network, and its job is to interview students in Japan who are applying to Cornell.



Message from you to the Club
(For members submitting updates or corrections, please describe the change: "new work address,""new private email," etc.)

Send e-mail to my

Personal e-mail address
Work e-mail address

May we publish your information in the Cornell Club of Japan printed membership directory?

Yes, publish
No, do not publish