Please fax this order form together with a copy of the following documents to your nearest H.I.S. branch. 1. Order form 2. Copy of passport (*Please send a copy for all passengers) 3. Copy of Australian visa (*Please send a copy for all passengers)

Passenger(s) Name(s)
Postal Address
Tel / Fax
E-mail Address
Date of Departure from Australia		Nationality of Passport
Type of Pass	7 Day Ordinary Pass 14 Day Ordinary Pass 21 Day Ordinary Pass 7 Day Green Pass 14 Day Green Pass 21 Day Green Pass * The rates of rail passes are subject to change due to currency fluctuation. Please contact H.I.S.. * Please send us a copy of your passport.
ELIGIBILITY for JAPAN RAIL PASS: 1.You must be a foreign tourist visiting Japan from abroad for sightseeing, under the entry status of “temporary visitor.” “Temporary visitor” entry status, according to Japan Immigration Law, allows a stay in Japan of 15 days or 90 days for “sightseeing, etc.”. When you enter Japan for sightseeing, entry personnel will stamp the passport as “temporary visitor”. Only persons who have a passport bearing this stamp can use a JAPAN RAIL PASS. Caution: If you visit Japan with an Exchange Order (H.I.S. Exchange Order) to be turned in for a JAPAN RAIL PASS, the exchange cannot be made unless they have “temporary visitor” status: to enter Japan under any other official status, such as “trainee” or “entertainer” will make the pass invalid. Please note that according to strict interpretation of the Japanese Immigration Law, “temporary visitor” status differs even from other types of stays that are also for only short time periods. 2.If you are a Japanese national living in a foreign country; a. who is qualified to live permanently in that country, or b. who is married to a non-Japanese residing in a country other than Japan. Note: Persons meeting conditions a or b above must be required to show proof of name at the point of purchase of an Exchange Order and obtaining a JAPAN RAIL PASS. Note: Australian Residents traveling on a Japanese Passport are not allowed to purchase JR East/West or Kyushu RailPasses. VALIDITY for JAPAN RAIL PASS: The valid period of a JAPAN RAIL PASS is the consecutive 7, 14, or 21 days beginning on the date the PASS is first used. Within three months from the date the Exchange Order was issued, you must turn in your Exchange Order to obtain their JAPAN RAIL PASS. At that time, it is necessary to specify the date that you want to start using the PASS. It can be any date within one month from the date the PASS is received. Once the PASS has a starting date written on it, the date cannot be changed. REFUND for JAPAN RAIL PASS: A JAPAN RAIL PASS can be refunded only within a valid period and before the first date for its use. 10% of cancellation fee plus A$100 refund processing fee per ticket will be charged. No refund can be made for any reason on or after the first day of use. NO REISSUE: Neither an order nor a pass can be reissued if lost or stolen. Please ensure its safekeeping. --> If your are eligible, please sign here; x　＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿

−Credit Card Details−　(*Please complete this section if you pay by credit card.)

A credit card surcharge between 1% and 3.5% will apply. Please enquire with your nearest H.I.S. branch.

Card Type:　 VISA / MASTER　　 AMEX　　 DINERS　　 JCB
Card No.:	Expiry Date(mm/yyyy):
Card Holder's Name:	Card Signature:
Total Amount: AUD$	Order Date: