JAPAN RAIL PASS ORDER FORM
※This service employs 128 bit SSL
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CLASS
Green (First Class)
Ordinary (Second Class)
DURATION
The selected number of days need to be consecutive. Note that once activated, the validity period of each pass cannot be changed nor prolonged.
7 days
14 days
21 days
HOW MANY JAPAN RAIL PASS(ES) DO YOU NEED
1
2
3
4
5
6 or more
DELIVERY
(A) Collection at Japan P.I.Travel office (Open Mon-Fri 09:00-18:00,)
(B) Delivery by courier service- will be add €20 within Belgium, €30 for Luxembourg
(C) Delivery by our staff- will be add €10 (within the 19 municipalities of Brussels and Zaventem only)
DATE & TIMING OF THE COLLECTION or DELIVERY
For example : 03 May 2019 at 11:00
DEPARTURE DATE
You must turn in your Exchange Order to obtain your JAPAN RAIL PASS within three months from the date the Exchange Order was issued
METHOD OF PAYMENT
(A) Bank transfer-You need to pay a bank transfer fee(Free of charge within Belgium and Europe)
(B) Cash- Please come to our office(Rue de Stassart 100, 1050 Brussels)
(C) Credit card - We accept: VISA, Master card, Diners club, American Express (We do not accept Debit card)
Email address
TITLE, NAME AND LAST NAME OF PURCHASER
TITLE, NAME AND LAST NAME OF PASSENGER 1 on YOUR PASSPORT
For example : Mr. Donald TRUMP (For the passenger 11 years or younger, Please fill the date of birth.)
TITLE, NAME AND LAST NAME OF PASSENGER 2 on YOUR PASSPORT
For example : Mr. Donald TRUMP (For the passenger 11 years or younger, Please fill the date of birth.)
TITLE, NAME AND LAST NAME OF PASSENGER 3 on YOUR PASSPORT
For example : Mr. Donald TRUMP (For the passenger 11 years or younger, Please fill the date of birth.)
TITLE, NAME AND LAST NAME OF PASSENGER 4 on YOUR PASSPORT
For example : Mr. Donald TRUMP (For the passenger 11 years or younger, Please fill the date of birth.)
TITLE, NAME AND LAST NAME OF PASSENGER 5 on YOUR PASSPORT
For example : Mr. Donald TRUMP (For the passenger 11 years or younger, Please fill the date of birth.)
Telephon number (1st priority)
Please add the country code if other than Belgium
Telephon number (2nd priority)
Please add the country code if other than Belgium
What is the best way to contact you?
Email
Phone
Either
If phone, when is the best time of day for a call-back?
09:00 - 12:00
12:00 - 15:00
15:00 - 18:00
MESSAGE AND OTHER REQUEST
SUBMIT
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JAPAN RAIL PASS ORDER FORM