Your Name
Birth Year
Year
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
other
e-mail
Phone Number
State
Select
non-USA residence
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
Washington DC
West Virginia
Wisconsin
Wyoming
Country in which you currently reside?
ex.) Japan, US and others
Nationality
Ethnicity
Marital Status
***choose***
single (never married)
Divorced (No children)
Divorced (Children living apart )
Divorced (Children living with part time)
Divorced (Children living with full time)
Widowed (No children)
Widowed (Children living apart )
Widowed (Children living with part time)
Widowed (Children living with full time)
other
Occupation
Choose
Public Servant
Self-Employed
Employee
Part-time employment
Military
Retired
Home Help
Student
Other
Annual Income
Choose
Less than US$50,000/Year
US$50K-US$75K/Year
US$75K-US$100K/Year
US$100K-US$150K/Year
US$150K-US$200K/Year
More than 200K/Year
Current thoughts on marriage?
Choose
I am anxious to marry immediately
If I find a good match, I would consider marriage
I am interested in marriage, but not very soon
Do you agree to come to Japan if you find a good match?
I agree
I disagree
Why do you want to meet Japanese lady as a lifelong partner?
By clicking on the "Sign Up!" button below, I certify that I have read and met all of Meet Japan Lady .com's Membership Qualifications .
We will only review Signup Forms that are completed fully. We will only consider men who are eligible for our membership according to our Membership Qualifications.