NICE Gourmet Japanese Course - Application Form

Whenever you write a calendar date, please write the year first, then the month, then day to insure smooth transfer to our database. Please do not use more than six digits in total (i.e. September 30th 1978 = YY/MM/DD = 78/09/30).

If an error occurs, please contact admissions@yamasa.org.

Personal Information

Family Name (Surname):
Given Name(s):
Middle Name(s):
(If dual nationality, indicate the country of the passport you plan to enter Japan on.)
If other:
Date of birth:
Post Code:
Street name/number:
If other:
Type of visa that I currently hold/intend to hold:
Email Address:
Telephone Number:
Passport No.:

Enrollment Information

Start date of course:
Have you ever studied Japanese before?
If you studied Japanese before, please describe your Japanese ability:
If you have any kind of allergies that may prevent you from participating in this course, please describe it:

Accommodation Information

At some stage during your studies, would you like to do a homestay?

If "No (Hotel)", skip this (Accommodation Information) section.
Do you smoke?
Do you mind if there is a smoker in the homestay family?
Are you allergic to animals or do you dislike any pets?
Are there any Japanese food dishes you dislike?/Any food allergies?
Do you have any other allergies or special requests?
Have you any prior experience of homestays?
Would you be willing to travel by bus and/or train if a homestay was located outside Okazaki?

(Please give more details if acceptance depends on how far the homestay is from Yamasa)
Please write a short outline of your hobbies/interests:
Please write a short outline detailing your family, work/school. It is best to include information that can give a family an insight into your lifestyle, personality etc.:

Arrival Information

I will use Yamasa Airport Pickup Service
(This service cost 12 000,- Yen):

Please note that if this box is not checked, the form cannot be sent.
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.