Referral ID
Japanese Name (Kanji)

Example: 山本

太郎
Please enter as described in the identity verification document
English Name (Romaji)

Example: YAMAMOTO

TARO
Mobile Phone
Example: 09088887777
Email
Required for authentication and password reset
Current Address
Please enter your current address correctly
Date of Birth
Gender
Password
Must have at least one uppercase letter, lowercase letter and 6-8 digits
Confirm Password
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