Registration Form

日本とハワイを繋ぐ国際結婚＆グローバル婚活サポート

アロハラニエージェンシハワイオフィシャルサイト

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Membership Registration Form
会員登録フォーム

Please fill out in English * Requirement fields

英語でご記入下さい。*印は必須項目です

First name*

Last name*

Email*

Phone*

Birthday*

Month

Day

Year

Address*

Work Place*

Job Position*

Preferred Contact Method

Phone

Text

LINE

LINE or WhatsApp ID if applicable

*All of the information above will remain confidential in your profile.

Age

Gender*

Male

Female

Height*

Nationality*

Ethnicity / Race*

If you answer "Mix" or "Other", please specify.

Language(s)*

English

Japanese

Spanish

Mandarin

Cantonese

French

German

Other

Birth Place*

Current City*

Educational Level*

Occupation & Job Title*

Annual Income*

Religion*

If you answer "Other", please specify

Marriage History

Do you have children?*

Yes

If you answer "Yes", how many children and how old are they?

Do you want children? How many?*

Living Situation*

Pet(s)*

1 Dog

2 Dogs

3 or more Dogs

1 Cat

2 Cats

3 or more Cats

1 Bird

2 Birds

3 or more Birds

*Other Animal

None

If you answer "Other Animal", please specify.

Personality*

Hobbies*

Health Condition*

If you have medical condition, please explain.

Do you smoke*

Do you drink?*

Age preference for your partner*

Early 20s

Late 20s

Early 30s

Late 40s

Early 50s

Late 50s

Early 60s

Late 60s

60s and older

No preference

Preference type for your partner*

Favorite food*

Favorite animal(s) and least favorite animal(s)

Favorite movie(s)

Favorite music

Please list the numbers in order of importance to you in a relationship: 1. Words of Affirmation 2. Quality Time 3. Receiving Gift 4. Act of Services 5. Physical Touch 貴方が交際で最も大切だと思う項目を順に並べて下さい。①肯定的な言葉　②クオリティータイム　③贈り物　④サービス行為　⑤身体的なタッチ*

Reasons for seeking an International Marriage*

How did you hear about us?*

If you answer "Friend or Family", "Referral" or "Other", please specify.

Please submit your photo ID, recent head shot and income verification along with the registration form.

Photo ID*

Head Shot

Income verification

Thank you for your cooperation! We will get back to you shortly!

* ALA Hawaii donates a portion of its profits to Make A Wish Hawaii, Shelter Hawaii, Operation Underground Railroad etc.

* ALA ハワイは収益の一部をメイクアウィッシュハワイ、シェルターハワイ、オペレーションアンダーグラウンドレイルロード等に寄付させて頂いてます。

Membership Registration Form ​会員登録フォーム

Membership Registration Form
会員登録フォーム