Dormitory Application Form
ラーチモント寮お申込みフォーム
Email address *
Name(氏名) *
Your answer
DOB(生年月日) *
MM
/
DD
/
YYYY
Age(年齢)
Your answer
SEX(性別) *
Country(出身) *
Your answer
Move-in Date(入居希望日) *
MM
/
DD
/
YYYY
Move-out Date(退居希望日)
MM
/
DD
/
YYYY
Stay Length(滞在期間)
Your answer
Room Type(部屋タイプ)
Are you a school staff?(学校名)
If you are a staff from language school, please write your school name. 語学学校のスタッフ様からのお申込みの場合は、以下に学校名をご記載くださいませ
Your answer
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