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Registration Form for Men in Japan

Please provide the following contact information (this contact information will not be given to anyone unless you request it):


First name

Last name



State / province / prefecture

Zip / postal code




How did you find TMA?


Please provide the following personal information:


Date of birth

Country of Citizenship

Country of Current Residence

Years in Current Country



Hair Color

Eye Color

Marital status


Warning! If you are married and posing as unmarried, be aware that you could be guilty of fraud and subject to civil and criminal penalties including heavy fines and jail sentences. TMA reserves the right to report violators to law enforcement authorities and seek prosecution and/or civil redress to the fullest extent of the law.



How long at present occupation?

Income (optional)

Religion (optional)



Hobbies / Interests

Do you want children someday?





Do you already have children?




If you have children, please give details including how many, what ages, and how they are being supported.

Do you smoke?






If you smoke, do you want to quit?





How would you describe your personality?


What is most important to you in life?


What countries have you been to?


Is there anything about you which your future spouse would want to know before becoming involved with you?

(U.S. clients click here to fill out a disclosure form required by U.S. law.  Filling out this form will be important if you ever want to get a visa for your fiancé or new wife.)


What are your hopes and plans for the future?


What message would you like to send to your future spouse?


No man's profile will be posted on the TMA website without permission.

To be accepted, you must submit a good photo of yourself. Profiles submitted without photos cannot be processed.

You may email your photo to:


Or, if you prefer TMA to scan your photo, you may send your photo by regular mail to:

Tobu Highline Ginza Bldg. 5F
Ginza 2-13-20, Chuo-ku, Tokyo
TMA, 104-8127 JAPAN


Free Bonus Offers to Newly Registering Clients

Sign up now and receive these free services! Just check the services which interests you:

I would like my photo and personal profile sent as a sample profile to all Japanese women who inquire to TMA (acceptance subject to approval by TMA).


I would like to add my email address to the TMA mailing list and be notified when new women's profiles are posted on the TMA site.


I would like to have my photo and profile posted on the TMA website (acceptance subject to approval by TMA).


I request that TMA send my profile and contact information to the women listed below and ask them to contact me if they are interested. Here are my choices:

Woman's name

Client number


Woman's name

Client number


Woman's name

Client number


Woman's name

Client number


Woman's name

Client number


Woman's name

Client number


Woman's name

Client number


Woman's name

Client number


I would like TMA to scan my photo and send it to me by Email.


I would like to be sent information about how I can place free personal ads in 7 publications widely read by Japanese women.


I would like to have a free membership in an online dating club with many Japanese women members.


Please choose a Membership type:

Sign up by Monday, May 12 and get a 20% discount on any membership!

Silver Membership: 3 months for ¥36,000 - 20% = ¥28,800

Gold Membership: 6 months for ¥54,000 - 20% = ¥43,200

Diamond Membership: 1 year for ¥72,000 - 20% = ¥57,600


You may specify an age range of at least 10 years for the woman you seek:

From (minimum)

Up to (maximum)


Please indicate how you prefer to receive your monthly profile mailings:

By postal mail

By email (as PDF files)


Please choose a Payment Method:

Bank transfer to Mitsui-Sumitomo Bank, Shinjuku Nishiguchi branch, regular account no. 8225840 (Account holder name: トランス パシフィック)

Bank transfer to Bank of Tokyo-Mitsubishi UFJ, Shinjuku Chuo branch, regular account no. 4394059 (Account holder name: トランスパシフィック ク リストファー ラッセル)

Cash by registered mail to: TMA, Tobu Highline Ginza Bldg. 5F, Ginza 2-13-20, Chuo-ku, Tokyo, 104-8127

Postal Transfer (Yuubin furikae) to トラン スパシフィック・マリッジ ・エージェンシー,  account number 10530 - 47737051

If you have any comments, questions, or messages for TMA staff, enter them here:

Please don't forget to send at least one photo either by email or by postal mail.


Declaration of Eligibility for Marriage

By submitting your registration information to TMA, you certify and attest, under penalty of perjury and false statement, that you are at least 18 years of age and NOT MARRIED. Furthermore, you understand that your participation in TMA's services is subject to the terms of the Transpacific Marriage Agency Agreement.


Signature (typing your name acts as your signature)


The date & time will be recorded when you click "Submit."