Short Intensive Language Acquisition Courses (SILAC) - Application Form

(You do not require a guarantor.)

If you need a guarantor, please click here. If you intend to study for longer than 3 months or are not sure of which visa you require please click here. If you intend to apply for any other course please click here.

To complete this form successfully you will need to know:
(a) the commencement date of the SILAC Module you wish to start your studies from, and
(b) the number of weeks you wish to study (2, 3, 4, 5, 6, 7, 8, 9, 10, 11 or 12 - you can also change this later).

Whenever you write a calendar date - please write the year first, then the month, then the day, in 6 digits. For Example: if you want to write 2015/DECEMBER/21 then write it as 15/12/21 (ie YY/MM/DD). This will ensure that the date will transfer into the database correctly.

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

Please, complete all sections.

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:
Native/mother language:
If other:
Indicate 1st foreign language (if applicable):
If other:
Indicate 2nd foreign language (if applicable):
If other:
Date of birth:
Place of Birth:
Marital Status:
Current Occupation:
Highest level of education completed:
If other please state:
Are you currently enrolled as a student in a university level program?
Are you a student at one of these universities?
If other:
Are your studies at Yamasa part of a formal Studyabroad program?
If you answered Yes to the above, please provide contact details of relevant faculty members or the studyabroad office for transcripts, credit arrangements etc (this can also be provided later):
Home Address:
(enter at least one address)
Address in Japan:
(If you don't have an address in Japan, please leave this blank.)
Email Address:
Telephone Number:
Fax number:
Passport No.:
(If you don't have a passport yet, please email it to us later.)
Passport Valid Until:

Course Information

Start date of SILAC program:
How long do you intend to study from your selected start date?
(You can change the length of study later)
Customized options
Option A: You can choose 1 to 5 Private lessons per week for 10 weeks. If you will pay for this option before the start date, tuition fee per 1 lesson will be 4000 Yen, after this it will cost you 5000 Yen per 1 lesson.

Option B: Would you like to participate in the Japanese for Business & Professional Purposes (Type B) course?
Note: Only students who can attend the whole JBPP Type B (9 weeks) can select this option.

For intermediate learners and above only. Please check available dates.
On my start date I will be:
Have you been to Japan before?:
Total number of visits:
Total length of stays in Japan:
(an approximation is OK)
Visa status on previous visit(s):

(Tick one or more)
Do you have any family in Japan?:
If Yes please give details:
Have you formally studied Japanese before? (If you haven't studied Japanese formally before, please skip to the Accommodation Information section below).
Where did you study Japanese?
Which textbooks/materials did you use? (To which chapter? Was the textbook in kana or romaji?)
Were your formal classes taught in Japanese only?
Were your teacher(s) qualified and native speakers of Japanese?
Can you read and write all of the hiragana & katakana?
Can you read and understand short passages written in Japanese hiragana/katakana?
Have you taken the Japanese Language Proficiency Test (JLPT):
Level: Year:
Have you taken the JETRO Business Japanese Test (BJT):
Year:  Enter score:
Approximately how many hours of class contact hours did you receive?
What are your main reasons for studying Japanese:

Accommodation Information

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

If "N/A", skip this (Accommodation Information) section.
When do you expect to arrive in Okazaki?
(Note you can change this later.)
If other please explain details.

All rooms are single.
Please contact us if you wish a shared room.
Please select 3 accommodation options.
All 3 options must be different or the form can`t be sent.
What is your first preference for accomodation for your program?
What is your second preference if that isn't available?
What is your third preference if that isn't available?
I need Yamasa to arrange futons/bedding for me.
If you answered Yes to the question above.
I authorize Yamasa to
I wish to
I will reserve my place by:

If you are taller than 182cm/6ft, please state height:

Homestay Information

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

If "No", skip this (Homestay 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)
What are your main reasons for wishing to participate in the homestay/homevisit program?
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.