Application Form

Application Form

Fill out the necessary contents and send the application form.
We will reply within 2 days. Application form sent after 6PM or on the weekends and holidays will be accepted the next school day.

If you are unable to submit the application form, please contact us at the address below and a member of staff will assist you.

Name First name :
Family name :
Passport Name First name :
Family name :
Passport No,
Date of Birth  Day  Month  Year
Gender
Nationality
Occupation
Post-code
Address Address :
State :  Country :
Telephone
Fax
E-Mail
E-Mail confirmation
Emergency contact name
Emergency contact telephone number
Emergency contact e-mail address
Emergency contact please write again as confirmation
*Please attach a picture of yourself in "jpg" , "gif" , or "png" format.
The file size must be less than 1MB.

Course Information

Course 1
Course
Course Start Date  Day  Month  Year
Course End Date  Day  Month  Year

If you wish to continue a different course after the one you indicated above,
please fill out the following section.

Course 2
Course
Course Start Date  Day  Month  Year
Course End Date  Day  Month  Year
Course 3
Course
Course Start Date  Day  Month  Year
Course End Date  Day  Month  Year

Accommodation Information

Require arrangement
*Please select the accommodation, if you selected "YES".
Arrivel date  Day  Month  Year
Departure date  Day  Month  Year
Do you like children?
Do you smoke?
Are you allergic to anything?  
Do you have any chronic diseases?  
Do you like pets?
Are you vegetarian?
What kind of food do you like?
What kind of food do you hate?
What is your hobby?
If you have any requests for your host family, please write them here.
Please write down your message to hostfamily.
Message Fill in the message box if you have any special requests.

Flight Infomation

Arrival date Min  O'clock Day Month Year
 
Flight No
Departure from Sapporo date Min O'clock Day Month Year
 
Flight No
Airport pickup service
*We will welcome you at the airport for an additional cost of 15,000 Yen.
*Those staying with a host family or a weekly apartment are required to use the pick-up service.
*If you have not booked yet, please let us know your flight information after it is confirmed.

Payment method *Please select your preferred payment method.

Payment method

Level of Japanese *All fields are required, so we can find a suitable class for you.

Level Level criteria is here.
Where have you studied Japanese?
How often do you study Japanese? Times in a WeekHours Per Week
How long have you studied Japanese? Years Months
Please write the name of the textbook you previously used.
*Please write the the textbook title and level (e.g. Minna no Nihongo 1, Minna no Nihongo 2, Genki 1, Genki 2)
Please write the name of the textbook you're using now. Textbook Name
  Progress/Chapter/Unit
Textbook Name
  Progress/Chapter/Unit
Textbook Name
  Progress/Chapter/Unit
*Please write the the textbook title and level (e.g. Minna no Nihongo 1, Minna no Nihongo 2, Genki 1, Genki 2)
Have you taken the JLPT?

When did you take it? Year Taken
HIRAGANA
KATAKANA
KANJI
Please write a detailed message about your Japanese ability.
*Please write as many details as possible. This message will help place you in the appropriate class.

Message

How did you find us?
Message


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