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Confirmation
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Asterisk (
*
) indicates a required item.
Desired program
Program name
*
Preferred date / time / no. of times
*
Participant Information
Name
*
Age
*
School year
*
Required for students.
Please select
Primary school 1st grade
Primary school 2nd grade
Primary school 3rd grade
Primary school 4th grade
Primary school 5th grade
Primary school 6th grade
Junior high school 1st grade
Junior high school 2nd grade
Junior high school 3rd grade
High school 1st grade
High school 2nd grade
High school 3rd grade
Vocational school 1st grade
Vocational school 2nd grade
Vocational school 3rd grade
Vocational school 4th grade
University 1st grade
University 2nd grade
University 3rd grade
University 4th grade
Graduate school
Address
Postal code
State/Province
Please select
Hokkaido
Aomori
Iwate
Miyagi
Akita
Yamagata
Fukushima
Tokyo
Ibaraki
Tochigi
Gunma
Saitama
Chiba
Kanagawa
Toyama
Ishikawa
Fukui
Nigata
Yamanashi
Nagano
Gifu
Shizuoka
Aichi
Mie
Shiga
Kyoto
Osaka
Hyogo
Nara
Wakayama
Tottori
Shimane
Okayama
Hiroshima
Yamaguchi
Tokushima
Kagawa
Ehime
Kochi
Fukuoka
Saga
Nagasaki
Kumamoto
Oita
Miyazaki
Kagoshima
Okinawa
Address 1
Address 2
Email Address
*
Verify email
*
Phone number (without hyphen)
*
Companion (Parent/guardian in parent/-child participation programs)
*
Yes
No
Name of companion
Inquiry details, other
Confirmation