Digital Nomad member APPLICATION FORM

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This is the Digital Nomad membership application form for ROKKONOMAD.
If you have any questions, please contact us at the email address below.

info@rokkonomad.org

How to participate in the Digital Nomad membership.
1) Apply from the Application Form ◀︎ Currently Here
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2) Availability check

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3) Confirmation of your reservation.
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4) Payment link of online credit card payment send by ROKKONOMAD Please pay by 1 week advance of your stay.

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5) Service starts

MAIL ADDRESS *

NAME *

OCCUPATION *

THE COMPANY YOU WORK FOR

SEX(We have shared shower so please answer it.) *

FEMALE

MALE

OTHER

AGE *

ADDRESS *

PHONE NUMBER *

SOCIAL ACCOUNT (INSTAGRAM, FACEBOOK, YOUR WEB PAGE..)

DATE YOU WISH TO START (APRIL 2024 - MARCH 2025) 　You may select multiple dates *

4/1

4/15

5/1

5/15

6/1

6/15

7/1

7/15

8/1

8/15

9/1

9/15

10/1

10/15

11/1

11/15

12/1

12/15

1/4

1/18

2/1

2/15

3/1

3/15

Required

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