ETP Association Membership Application/Resignation Form

(Mandatory field) Please fill in all the fields

I would like to:apply for a new membership
change my membership statuifrom a general member to a full member
cancel my membership
Please pay \3,000 for the training materials to join as a full member,
or to switch from a general membership to a full membership
Please pay by PayPal within one week of the day of your application.
Name e.g. George Washington
Type of Membership Full member General member
Date of Birth e.g. 12 Jan., 1985
GenderF Male Female
ZIP code
address
Apartment Name
Telephone number
E-mail
I support the objectives of ETP. I do not support the objectives of ETP.
I would like to receive your newsletter via E-mail. YES NO
Write down your questions, opinions and/or requests within 200 words*.
If you would like to resign:
Tell us the reason(s) for your resignation within 500 words*.

Please answer the following survey:

Q1. How did you hear about us?
(You can choose more than one answer.)

In a magazine Recommended by a friend Heard from others
It found it by chance
Others

Q2. Tell us about the search keyword(s) that you used.
(You can choose more than one answer.)

Please choose the search keyword(s) that you used on a search engine from the choices below:
ETP Association Japanology Spiritual world Martial art Self-enlightenment
Other

Q3. Tell us about the search engine that you regularly use.
(You can choose more than one answer.)

Yahoo Google infoseek goo Excite MSN
Other

Thank you for your cooperation.