Apply as a Traveler

Tell us your travel plans, schedule, and required support.

Notice: Our staff will contact you within 3 business days after your application.

Basic Information

Full Name*

Name (Furigana)*

Email Address*

Phone Number*

Date of Birth*

Gender*

Disability & Support Needs

Disability Type(s)*

Visual impairmentHearing / speech impairmentPhysical disabilityInternal disabilityIntellectual disabilityMental disabilityOther

Mobility Level*

Required Assistance*

Wheelchair operationTransfer assistanceWalking assistanceMeal assistanceRestroom assistanceCommunication supportLuggage managementTransit boarding assistanceSightseeing / info gatheringMedication managementOther

Medical / Health Notes

Travel Information

Destination*

Travel Start Date*

Travel End Date*

Purpose / Wishes

Accommodation Type

Budget

Caregiver Preferences (Optional)

Preferred Caregiver Gender

Preferred Caregiver Age Range

Message to Caregiver

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FUKU-TABI

A matching service connecting travelers who need physical support with experienced caregivers in Kagoshima.

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Contact

Feel free to contact us with any questions.

[email protected]

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