Course Application Form

(Student Visa Not Required)

Application date

04/18/2025 07:03:32 PM

Course Information

Personal Information

Family name

Given name

Middle name (if applicable)

Name in Chinese (if applicable)

English name (if applicable):
(Hong Kong, Singapore or Taiwan nationalities only.)

Nationality
If dual nationality, indicate the country of the passport you plan to enter Japan on.

Native language

1st foreign language (if applicable)

Sex

Date of birth

(Year/Month/Day)

Current occupation

Highest level of education completed

Other

Home address (please provide in latin alphabet only)

Home address
Postcode/ZIP
Country

Address in Japan (If applicable)

Address in Japan
Postcode/ZIP
Prefecture

Email address

Telephone number

Emergency contact (phone number, email, etc.)

Passport number
(If you don't have a passport yet, please email it to us later.)

Passport valid until

Passport photo upload

Type of visa that you intend to hold /currently hold

Residence card No. (if applicable)

Residence card valid until

Upload photo of your residence card

3x4 photo upload

Please write a short outline of your hobbies/interests

Please enter any extra information you would like us to know before your arrival at YAMASA here

Accommodation Information

Will you require Yamasa's housing office to arrange accommodation for you?

Preferable check-in day (can be changed later)

Preferable check-out day (can be changed later)

All rooms are single.

Please select all 5 accommodation options.

1st accomodation choice

2nd accomodation choice

3rd accomodation choice

4th accomodation choice

5th accomodation choice

6th accomodation choice

7th accomodation choice

8th accomodation choice

Will you need Yamasa to arrange futons/bedding?

"Rental Futon" and "Purchased Futon" are a futon and pillow set.
Please contact us at least 10 days in advance in case of any changes or cancellations.
*The futon pictured and the ones available for rental and purchase will differ slightly.
*For those staying for more than 70 days, purchasing a futon will be more cost-effective.

	Except for some rooms, there is no mattress on the bed so you can not sleep without Futon because the bed is hard without it. Especially from autumn to early spring, it will also become cold in Okazaki and you can not sleep without Futon, so please prepare your own sleeping bag etc if you do not need Futon. You can rent Futon for only one week , and also you can purchase it during that period.
	The photo of the bed without Futon.

Learning History

Have you formally studied Japanese before?
Did you study at YAMASA?
If you did study at YAMASA before, please provide your YAMASA student number, if you remember it.
What school did you study Japanese at?
Approximatelly how many class contact hours did you received?
Which textbooks/materials did you use? To which chapter?
Were your classes taught in Japanese only?
What are your main reasons for studying Japanese?
Can you read hiragana and katakana?
Have you passed any level of JLPT test?

Arrival Information

I will use Yamasa Airport Pickup Service (This service cost 12 000,- Yen):
I will use JR Okazaki Station/Meitetsu Higashi Okazaki Station Free Pickup Service. (weekdays 9:00~16:00)
I will use out of hours service. *Out of hours, a service charge of 20,000 yen will be applied.:

File Upload

Upload your resume if you intend to work in Japan after graduating from Yamasa:

Please note that if this box is not checked, the form cannot be sent.
- I confirm that I have read, fully understand and agree with the Yamasa Institute's privacy policy and cancellation/refund policy.
　
Please contact admissions@yamasa.org if you require further information.

Intended course
	AIJP Course: From 16 to 8 weeks before classes start.
Course start date
Course length
Course ends
Expected start of lessons
Days of the week	Monday Tuesday Wednesday Thursday Friday Saturday
Desired time of lessons	From : to : Students who would like to take lessons on Saturday or in the evening, please contact admissions@yamasa.org.
Desired total number of lessons
Desired lessons per week
Note	Our staff will ask you to take an online test and send a questionnaire about your study and Japanese proficiency before your start date.
	First time
Desired date of trial lesson:	Desired time of trial lesson: :
	Second time onward
Desired date of next lesson:
Days of the week	Monday Tuesday Wednesday Thursday Friday Saturday
Monday lesson start:	:
Tuesday lesson start:	:
Wednesday lesson start:	:
Thursday lesson start:	:
Friday lesson start:	:
Saturday lesson start:	:
Number of private lessons: