LADIES APPLICATION FORM

 Please fill out below  and describe your Profile. then send your some picture to  address below. 
Name First name Family Name Nick name
Date of Birth Age
Address
Height   Weight  
Occupation 　 Education
Hobbies Education
Phone No. E_mail Adress  (*1)
　 Please introduce yourself (Phisically, family, hobbies, situation etc. ) and what is your  ideal gentleman  as your partoner in marriage? (Age rabge , his character, height, looks, financial etc.) (Please describe by English)
　

Please fill out above form   and describe your Profile. then send your  picture to following address.. 
(*1) If you do not have e_mail address, Firstly make your Free e_mail Account at hotmail.com
 Our Address :to Keisuke  Shimaoka
Grace Mansion 902, 3-3-7, Iizuka, Kawaguchi, Saitama Pref. Japan.