Japan Rail Pass, JR Pass Order Form

Before you pro ceed !

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Important:

Please read and understand the eligibility rules for the JR Pass. I understand that failure to meet these requirements could result in the failure of the JR Pass to be issued once in Japan.

Japan Rail Pass West / JR Pass West - Pricing and Duration Information.

Kansai Area Pass

Sanyo Area Pass

Type

Pass Price

Type

Pass Price

Duration	Adult	Child	Duration	Adult	Child
1-day	¥ 2,000	¥ 1,000	4-day	¥ 20,000	¥ 10,000
2-day	¥ 4,000	¥ 2,000	8-day	¥ 30,000	¥ 15,000
3-day	¥ 5,000	¥ 2,500
4-day	¥ 6,000	¥ 3,000

Age 12 & Over

Age's 6 to 11

Age 12 & Over

Age's 6 to 11

Japan Rail Pass Exchange Order Form / Note: Required Fields are marked with a * and Red Font.

Contact and Shipping Information

JR Pass Passenger List (Must have at least one passenger listed. Name MUST be as it appears on passport).

*First Name:
*Last Name:
Middle Name:
*Phone:
Ext:
*Email:
*Confirmed Email:
Company
*Address:
*City:
*State:
*Zipcode:


	Travel Agent Information Inquire

Travel Agent
IATA Number
Agent Email
Confirm Email:

*Last Name:	*First:	Middle:	*Type:
Last Name:	First:	Middle:	Type:
Last Name:	First:	Middle:	Type:
Last Name:	First:	Middle:	Type:
Last Name:	First:	Middle:	Type:

Important Information Here! Please read it and check in the box below.

Otherwise your request won't be proceeded.

* I have read and understood the restrictions and requirements for purchasing JR Passes:

YES

Credit Card Information

*Name as it appears on Credit Card:

*Credit Card Type:

*Card Number:

*Exp:

(MM/YY)

*Security Code (Last three or four digits from the signature panel on back of the Credit Card):

Credit Billing Address Information

*Card Holder Name:

*Street Address:

*City:

*State:

*Zipcode:

Special request or instructions (meals, disability access, smoking car, etc.) 700 Characters Max:

Important !

Date you must receive the Exchange Order by (You must have the exchange order before you depart for Japan)

	* Please select the date here:

Shipping method, required: * Please refer to our shipping and handling information.

STOP !

Please check your information before you submit. Print this page for your records.

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