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Inquiry Form / Consultation Request Form

Name in kanji
(mandatory)
LAST Enter your surname.(e.g.,) 日米
FIRST Enter your first name.(e.g.,) 太郎
Name in Latin alphabet (mandatory)
* In capital letters
LAST Enter your surname.(e.g.,) NICHIBEI
FIRST Enter your first name.(e.g.,) TARO
Gender Male  Female
E-mail address
(mandatory)

Enter your e-mail address.The e-mail address is invalid.
(e.g.,) xxx@nichibei.ac.jp
E-mail address
(mandatory)
Enter your e-mail address.The e-mail address is not correct. Please enter it again.
Please rekey it.
Phone No.
(mandatory)
Enter your phone number.(e.g.,) 03-1234-5678
Nationality
Current address In Japan  Overseas
 
Japanese learning experience Yes I have. (Please answer the questions below.)  No, I haven’t.
Length of learning
The title of the textbook last used The title of the textbook 
Finished / Not finished To section No.
Can you read or write hiragana? Yes, I can read.  Yes, I can write.
Can you read kanji?
Have you ever taken JLPT? No, I haven’t.
Yes, I have, in . (Please specify the year)
Did you pass it?
Target term for registering Please choose month first, then year.
From (month), (year)
Your target Program/Course
(You can choose more than one.)
Regular Program (5 days a week)
   I would like to apply for a Student Visa (6 mons. 2 yrs.).
   I don’t need a Student Visa.
Part-time Program (1 to 2 days a week)
   Early morning course  Afternoon course
   Evening course  Saturday course
Private Lessons
Your target study contents
(You can choose more than one.)
Daily conversation  Business conversation  TV news
JLPT  BJT  Other

Reservation for Course Consultation (about 20 to 30 min.)

Time frame for consultation Mon.–Thu. 13:30–19:00, Friday 13:30–16:30, Saturday 13:30–16:00

Time frame for consultation is on the right. Please state your choice.
* Level-check interview will be conducted for those applying for the Part-time Program.

Time & day of your choice Please select or fill in the month, day and time of your choice.
month  day   
o’clock  min.
Questions

Protection of personal data

Since all personal date are processed by the industry standard CPI cryptographic technology, they are secure and inaccessible by third parties.

The School exercises utmost care in data management. The School handles students’ personal information strictly in accordance with the rules stipulated bellow.

  1. The School will not collect personal information without the consent of students. When the School asks for students’ personal information, it will specify the purposes beforehand. The personal information will not be used for any other purpose than those specified in Item 4 below.
  2. The School will not share the personal information of the students with a third party other than the agencies with which the School has signed appropriate contracts regarding security control measures.
  3. The School will not consign the management of the students’ personal information to a third party other than the agencies with which the School has signed appropriate contracts regarding security control measures.
  4. Purposes of obtaining the personal information of students
    • To conduct classes and run curricula
    • To contact students regarding School affairs
    • To notify them of upcoming programs and courses
    • To announce upcoming events and activities of the School, IEC or cosponsor organizations
    • To e-mail or mail School newsletters

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