日本語課程申請書            Japanese Course Application Form
東京ひろがり日本語學校 Tokyo Hirogari Japanese language school
 Tel:(+81)42-850-9917    Email:  info@hirogari.tokyo
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申し込みコース Application course *
Required
姓名( 英文拼音名字 )Name ( English notation )
*
姓名( 中文漢字名字 ) Name ( Kanji notation )  ※Only for people in the Kanji area *

姓名( 日語假名的拼音 ) Name ( katakana notation )  ※ Only for those who can write katakana

西元出生年月日 Date of birth
*
MM
/
DD
/
YYYY
國籍 Nationality
*
居住地區( 居住地非日本地區,可書寫英文,或是中文 )
Place of residence (English or Japanese notation)
*
連絡電話 Contact phone number
e-mail 信箱
*
職業 Occupation
*
請問是否有參加過日本語能力試驗( JLPT )?
If you have taken the Japanese Language Proficiency Test, please tell us the grade and whether you passed or failed.
N1
N2
N3
N4
N5
沒有報名參加過
合格 Pass
不合格 Not Pass
在留資格( 目前居住、滯留於日本的簽證資格 )
Status of residence ( only for those staying in Japan )
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