Please fill in information and your question/inquiry below, and then click the Submit button. Be sure to enter information into all required fields, including your name and e-mail address. If someone makes an inquiry on your behalf (a substitute inquirer), the inquirer must enter his/her contact information (e-mail address or telephone number). For details on how we manage your personal information, please refer to the school’s Privacy Policy.

※ Asterisks indicate required items to be filled.

Last name (required):　※ e.g.: Smith
Middle name:
First name (required):※ e.g.: John
Last name
(in alphabets):		 e.g.: Smith
Middle name
(in alphabets):
First name
(in alphabets):		 e.g.: John
Nationality:※ e.g.: USA
Gender: 　
Date of birth:※ Year Month Day
Address:
e.g.: 818 Street, San Francisco, CA
Telephone number: e.g.: 415-000-6000
E-mail　※
e.g.: john@francisco.com
Contact info of a substitute inquirer
(e-mail or phone number):
e.g.: paul@california.com
Do you want us to send an application form to you? 　
Your desired course:(Multiple answer accepted.)











Application for student visa at our school
　　Reason:　

What type of visa do you have now?
（）
Your desired month of enrollment:※ Year Month
Your desired length of study:※ Year(s) Month(s)
Your desired study time per week: hours/week
Naganuma student dormitory Wish to reside in the dormitory
Total length of time you spent in the study of Japanese:※ Year(s) Month(s)
Tests you passed:
e.g.: Japanese Language Proficiency Test Level 3, 2013
　　 BJT Business Japanese Proficiency Test Level J1, 2012
Your question and/or inquiry: