Contact

Japan

MembershipRequired

YesNo

NameRequired

Name（Phonetic）Required

PhoneRequired

EmailRequired

AddressRequired

AgeRequired

years old

GenderRequired

MaleFemale

OccupationRequired

Company EmployeeOrganization StaffSelf-EmployedGovernment EmployeeSelf-EmployedForestryAgricultureFisheriesOther

FamilyRequired

SingleMarried (with children)Married (without children)

About VisitsRequired

Name of the Producer You Wish to Visit

1. First Prefferd Date
   --10am11am12pm1pm2pm3pm4pm Around What Time

2. Second Preferred Date
   --10am11am12pm1pm2pm3pm4pm Around What Time

3. Third Preferred Date
   --10am11am12pm1pm2pm3pm4pm Around What Time

Other (Preferred date to be arranged with the field owner)

Purpose of the VisitRequired

To Learn About Shumei Natural AgricultureInterestedWant to Experience ItWant to See the CropsOther

Farming ExperienceRequired

YesNo

Questions or Comments