Business Member Pre-registration Form

• Please ensure to read below notes before completing the form.


• * This is pre-registration form for new members who have not canceled Costco membership in the last 12 months.
• * Please visit membership counter at the nearest Costco warehouse to complete registration.
• * You need to present business identification together with the applicant's photo ID at the membership counter.
• Business identification needs to include name of business, name of owner/president and address of company.
• Examples of documents are;
•  ・Company representative's business card
•  ・Utility bills
•  ・Farming certification and/or
•  ・Copy of a company register
•  ・Business permit is accepted if the company name is not available

Primary Card

*  …Required.
**…Minimum One telephone number required.

Nearest Warehouse*

----- Sapporo Kaminoyama Tomiya Makuhari Kanazawa Seaside Kawasaki Iruma Shinmisato Maebashi Zama Tamasakai Chiba New Town Tsukuba Hitachinaka Kisarazu Chubu Airport Nonoichi Imizu Gifu Hashima Hamamatsu Amagasaki Kyoto Yawata Kobe Izumi Hiroshima Hisayama Kitakyushu

Company Name*

Classification*

----- Agriculture, forestry, horticulture, fisheries, animal husbandry Real estate, hotels, B & Bs Food and Drink Industry, food, catering, bakery Manufacturing, wholesale trade, export business Transportation, warehousing, utilities Retail food, liquor sales, convenience stores Electronics store, appliances, general machinery Finance, insurance, securities Non-food shops, clothes, beauty, bath Printing, advertising, consulting, design Entertainment related industries, other Medical care, medical services, pharmaceutical Education, religion, art, and social services Building materials, machinery and equipment, repair shops Government, government agency, facility Automobile, sale, petrol station Construction Profession, professional services Non-profit organizations, organizations Internet

Primary Member Name*

First Name

Last Name

Company Address*

Zip Code

－

Prefecture (Auto Input)

City/Town/Ward (Auto Input)

Address 1

Address 2

Company Phone Number**

Mobile Phone Number**

Email Address*

Re-enter Email Address*

Date of Birth*

Year:Month:Day:

Sex*

Sex

MaleFemale

ID*

ID Type

Id Type

SpecialistDriver's LicenceInsurance CardPassportEmployee IDOther

ID Number [The social security number is not acceptable]

Household Card　(Optional) *Spouse / Domestic Partner

A free Household card is available to a Primary cardholder’s spouse, domestic partner, or immediate family member over the age of 18 and living at the same residential address. Household cardholders will be asked to present proof that they live at the same address as the Primary cardholder.

Request Free Household Card

Name*

First Name

Last Name

Email Address

Re-enter Email Address

Date of Birth*

Year:Month:Day:

Sex*

Secondary Sex

MaleFemale

ID*

ID Type

Secondary Id Type

SpecialistDriver's LicenceInsurance CardPassportEmployee IDOther

ID Number [The social security number is not acceptable]

Business Add on Card

Maximum of 6 add-on cards can be added on to the business primary Member.
(Annual fee for add-on is required.)
If you want to be issued an add-on card, please visit any local Costco warehouse with Employment document with your company's name and ID.

Please check the following item for confirmation.

I did not cancel Costco membership within last 12 months.

Submission of this application by clicking the "Accept" button shown below constitutes acceptance of Costco's Member Privileges and Conditions, and Privacy Statement.

Accept