御祈祷申込書 Application Form for Gokito, Special Prayer アメリカ椿大神社 Tsubaki Grand Shrine of America Applicant's Information Prayer Request Ceremony 御祈祷 Please circle one Description Date 日付 Name 氏名 Oharai 大祓 Purification 1 Address 住所 2 Shingan Joju Kigan 心願成就 3 Kanai Anzen Kigan 家内安全 Prayer for Health, Happiness,Safe and Prosperity Family Safety Syobai Hanjo Kigan 商売繁盛 Business Success 4 Dispel Misfortune 5 Yakuyoke Kigan 厄除け祈願 Relationship 6 Hatsumiya Mairi Kigan 初宮参り祈願 Prayer for Baby's First Shrine Visit 7 Anzan Kigan 安産祈願 Safety Birth Relationship Relationship 8 Budo/Aikido Jotatsu Kigan Successful Training 武道/合気道上達祈願 Relationship 9 Kotsu Anzen Kigan 交通安全祈願 Relationship 10 その他 Company Name 会社名 Date of Birth 生年月日 Family Information Name お名前 Birth Date Name お名前 Birth Date Name お名前 Birth Date Name お名前 Birth Date Name お名前 Birth Date Traffic Safety Hatsuhoryo 初穂料 (Ceremony Fee) minimum $20 $ minimum $50 $ minimum $50 $ minimum $50 $ minimum $50 $ minimum $50 $ minimum $50 $ minimum $50 $ minimum $50 $ per person Others Hatsuhoryo Amount 初穂料 $
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