Will you fill (or check 'x') the following "[]"?
Thank you.

(1)Period y[]/m[]/d[]~y []/m[]/d[]<--except the departing date.([]nights)
(2)Room's type[]Shared room []Private room
(3)Your name (First name and FAMILY NAME)
First name[] Family name (in Capital)[][]male []female
First name[] Family name (in Capital)[][]male []female
First name[] Family name (in Capital)[][]male []female
(4)Phone[] Fax (if available)[] Mobile phone[]
*Please insert "-" between the prefix.
(5)Your address
c/o []
Address []
Postal number [] Country []
(6)E-mail []
(7)E-mail of mobilephone []
(8)Meals
[]evening meals and breakfast []only evening meal []only breakfast []no meals
(9)How to travel
to Kagoshima[] to Yakushima[]
(10)Arrival at Yakushima (about)[]:[] / Toppy, Rocket or Plane booking []done []not yet
(11)Questions
*Place return after each question.
[]
(12)How did you find Chinryu-An? []
[]The Lonely Planet Japan, []The Rough Guide Japan, []other website[], []introduced by[], []others[],

Please read below "Notice!!" carefully, check your information once again, when you agree, attach and send by plain text e-mail.
Please tell us if you don't receive any reply in the following 3-4 days, and inform above items and your e-mail address.

**NOTICE!!
**We accept 3 or less persons in a group (for the priority to individuals).
**We accept age of over 12 years old.
**The cancel charge will be required from 1 day before the arrival (1 week before at high seasons), if you don't inform us of the cancellation from 1 day before the arrival (1 week before at high seasons) or without notice.
**The cancellation should be made by the telephone call. We don't accept it by e-mail.
**We can't prepare 'YUKATA' toiletary (towell, soap,shaver), so please bring your own.