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Japanese Bead Embroidery Online Registration

*BEFORE FILLING THE APPLICATION, If you have not filed your credit card with us, please contact JEC by phone or fax
Please fill in the required fields then click on Confirm button
* is required field.
First Name*
Last Name*
Steet Address*
State/Province*
Postal/Zip code*
Country*
Phone*
Please do not include parenthesis. ex. 1-770-321-3210
Fax
Please do not include parenthesis. ex. 1-770-321-3210
E-mail*
E-mail confirmation*
Class to register*
Please select one or more classes
  
  
  
  
  
  
450 Club*
Are you a member of 450 Club?
    
Piece(s) you will be working on in the class*
Please indicate the piece(s) you will be working on in the class below.
Kit Order
Price with * mark includes clasp and/or chain. Fixing, to be done professionally in Japan, is additional (130.00 USD - 190.00 USD)
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
Shipment
Method of Payment*
Last 4 digits of Credit Card#*
Expiration Date*
If 13/03, enter 1303
CVV*
Comment

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