Internet Application Form

Please fill out the following form. This is a preliminary application to find out which service is the best for you in your area. Once your application is sent, a staff member will contact you.

Services of Interest
Full Name
Phone Number
Address (Ex. 225-1 Hamagawa Chatan)
PrefectureOkinawa (for customers in mainland Japan, please go to www.glbbkanto.jp)
Housing Agency
Email Address
  I understand that GLBB will not release my personal information to any third party.
I have read the acceptable use policy of GLBB and agree to abide by it.
** By clicking Apply for consultation below GLBB will receive any personal information input above. You agree that GLBB will contact you via your contact number. You understand that GLBB will NOT release your personal information to ANY third party.