Ceremony Application Form 202010



Gokitō Request Form



Gokitō fee donation is minimum $100 per person plus shipping fees.


You will receive one Charm.


ご祈祷料(御玉串料)は 、PayPalでも受付けています。QRコード、または、下記リンクをご利用ください。

We accept ceremony fee donations (Otamagushiryō) via PayPal.

Please use the QR code or this link:





人生の節目アルバム お詣りの記録 (御初穂料20ドル)


Please let us know if you would like to obtain

"Visit Record and Milestone Album" ($20)

which you can keep your Goshuin and photos. 

※Information submitted into this form will be used only for Gokitō ceremony and Shrine administrative purposes.
It is not sold or shared. Contact us to have your information removed.


Additional Name(s)

Name of Companion(s) (i.e. parent, partner, etc. )

Their name(s) may be read out loud in the service.

Ceremony donation fee (Otamagushiryo)

Please donate a minimum of $100 per ceremony plus shipping when applicable.            

We accept donations via check or PayPal.  

Payable to: Shinto Shrine of Shusse Inari in America

Paypal: PayPal@ShintoInari.org



Event release Subscription

If you would you like to receive information about our events and seasonal Gokitō, please submit our sign-up form.


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