Chihiro Art Museum Application for Group Visits

Please print this page and submit the completed form to the museum by mail or fax so that it will be received in advance of your visit.   Please include your available brochures or leaflets that your group may have prepared in anticipation of this visit.

Your Group Name   Your Name & Address   Tel .                                                 Fax Travel Agency   Travel Agency's Address   Tel .                                                 Fax Date and Time           of Your Visit   Number of Visitors Adults   Gender   Male        /       Female   Seniors(65 and older)     Total Number of Vititors   (not including chilidren under 5)     Junior High  & High School Students   Elementary School                        Students   Children under 5   Gallery Talk *      Yes   /   No   Have You been to Chihiro Art Museum before?           No  /  Once  /  Twice  /  Three Times  /  More   What made you plan this visit to the museum?       NewsPaper Articles:  Asahi /Yomiuri /Mainichi /Akahata /Other:       Magagine:       TV Program:       Invited by Someone in the Group       Recommended by a Friend       Travel Agency's Tour       Other:

*  Gallery talks are available upon request. Talks, usually conducted in Japanese, last about 10 to 15 minutes and cover the museum's history, Chihiro Iwasaki and current exhibitions. For talks in English, please submit a request prior to your visit. Groups of fewer than 20 people are also welcome to make appointments for gallery talks (although group admission discounts will not apply).

Chihiro Art Museum Tokyo 4-7-2, Shimo-Shakujii, Nerima-ku, Tokyo 177-0042, Japan tel. +81-3-3995-0612 fax +81-3-3995-0680

Chihiro Art Museum Azumino Nisnihara, Matsukawa-mura, Kita-Azumi-gun, Nagano 399-8501, Japan tel. +81-261-62-0772 fax +81-261-62-0774