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2020 Reservation NIHON TO-KEN HOZON KAI 日本刀剣保存会 2020 San Francisco Shinsa RESERVATIONS FORM Name: ______________________________________________________ Date Submitted: ___________ (Family Name) (Given Name) (Middle init.) Address: __________________________________________________________________________________________ City: __________________________________________________ State/Province:_____________ (Zip): ___________________ Country: ____________________ Note: This address is where any Kantei-sho (Papers) will be sent. Any corrections should be made when you collect your items. ========================================================================== Swords Submitted For Shinsa: Type Number Reservation Number Kantei-sho Submitted Submitted Total Passed Fee Total Blades _______________ x$100? = $____________========== _____________ x$150? = $_____________ Kodogu/Koshirae Summary Sheet Kodogu/Koshirae ________ x$100? = $_________ ============== ________ x$150? = $______________ Reservation Total: ___________ $______________ ___________ $________________ GRAND TOTAL BALANCE $________(to be completed by cashier) By Shinsa Cashier: Received Origami Fees on ___________________ by _______________________ Comments or Special Instructions: _______________________________________________________ BY CUSTOMER: I have received back all items submitted to the Shinsa by me (with tag numbers noted on back) in good order and condition: Signed:_______________________________________________ Date: __________________________ NIHON TO-KEN HOZON KAI 日本刀剣保存会 NTHK 2020 San Francisco Shinsa Katana/Kodogu/Koshirae Shinsa 2020 Tag Numbers for ___________________________________________ Tag Number Item Type Passed Comments / Points 1._____________To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No 2. _____________To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No 3. _____________To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No 4._____________ To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No 5. _____________To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No 6._____________ To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No 7. _____________To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No 8._____________ To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No 9. _____________To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No 10. _____________To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No 11. _____________To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No 12. _____________To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No 13._____________ To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No 14. _____________To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No 15. _____________To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No 16. _____________To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No 17. _____________To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No 18. _____________To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No 19. _____________To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No 20._____________ To-ken ______________________ Kodogu, ______________Koshirae__________ Yes No Blade Types: Tachi, Katana, Wakizashi, Tanto, Yari, Naginata, Nagamaki, Yajiri, kogatana, other Kodogu Types: Tsuba, Fuchi/Kashira, Menuki, Kozuka, Kogai, Kurikata, other: Koshirae Types: Tachi, Katana, Wakizashi, Tanto, Aikuchi, Yari, Naginata, other: If mailing a check; 1. Print out the registration form (you may send a scan if using Paypal) 2. Complete the form and send to address below. 3. Include your check or money order for the registration fees only. (Total must include $100 ea. for the total number of slots you want.) Note: Fees for certificates are to be paid at the time of the Shinsa for all items that pass. We will only accept CASH on the day of the shinsa. The cost for each item that passes is an additional $150.00. Please tell us your preferred time of Shinsa: Friday: AM PM Saturday: AM PM Sunday: AM PM Send Shinsa Reservations and checks for any payment to: NTHK 2020 Shinsa P.O. Box 3013 Los Altos, California USA 94024-0013 The 2020 NTHK Shinsa is brought to you in conjunction with the 2020 Northern California Japanese Sword Show - www.ncsjc.org Note: If you have trouble printing these forms email us and we’ll send them to you; [email protected] page3 .
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