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The Japan and World Helpline
Card Applications

Email this form, or print out and send to: CPO 833, Tokyo Japan 100-91

I would like to receive
The Japan Helpline Card
The World Helpline Card

Last Name:

First Name:

Email:

Nationality:

Mailing Address (where to send card):

Postal Code:





(Optional Section)

The following information is optional.
We request it because the helplines have search systems in case of disaster situations such as earthquakes. By providing us with extra data The Japan and World Helplines would be able to facilitate medical agencies in tending to you or assist your family/friends in locating you. Please feel free to partially fill out this section.

Telephone:

Fax:

Passport No:

Alien Registration No:

Date of Birth:

Age:

Blood Type:

Allergies:

Contact Telephone Number in Home Country:

Contact Fax Number in Home Country:

Doctor Contact:

Other Information:


The Japan and World Helplines are non-profit, non-governmental services dedicated to the international community. We offer advice on anything from a simple question to an emergency situation, or sometimes we just listen.
For more information, our toll-free number is 0120-46-1997.
Outside Japan, we can be reached by phone at 813-3435-8017, or by fax at 813-3588-1202.

The Japan and World Helpline Cards are credit-card sized and fit neatly into your wallet. The Japan Helpline Card contains essential telephone numbers and information for non-Japanese speakers, as well as a numbered phrase list in English and Japanese useful in cases of emergency. The World Helpline Card lists the emergency numbers of the most commonly used places worldwide. Both cards are free-of-charge.

 

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