Your name:

e-mail address:

How long have you lived in Japan?

How much longer do you plan to live in Japan?

Do you consider Japan to be your permanent domicile?

Yes No

Are you a non-Japanese married to a Japanese national?

Yes No

Are you a member of UMJ?

Yes No

Why are you interested in UMJ?

Have you attended a meeting in the past 3 months?

YesNo

What aspects of life in Japan cause you difficulty?

Employment	Marriage-related	Immigration
Living conditions	Social customs	Legal
Raising Children	Language	Food
Cost of living Education	Other

What aspects of life in Japan are attractive to you?

Employment	Raising Children	Food
Living conditions	Social customs	Other
Cost of living Education	Language

What problems have you had regarding your employment situation or life in Japan? Please elaborate about any specific problems that you have had.

Recently, have you had any problems with your life in Japan? Please describe.

What kinds of assistance did you need?

From where did you get that assistance?

Do you see a need for an organization like UMJ?

YesNo

How can UMJ be most useful to you?

What kinds of things do you hope that UMJ can assist you with?

What kinds of issues would you like UMJ to work on?

Non-Japanese spouse's inclusion on the Juminhyo

Discrimination Issues

Re-entry visas and other taxes aimed at foreigners

In what ways can you assist UMJ?

Please add any comments about life in Japan, the role of UMJ, or other related topic.