CSAJ Student Survey
Thank you for registering with us. Membership fee is free!
All Cambodian students currently studying and staying in Japan for a minimum of 6 months are eligible.

It will take approximately 3 minutes to complete the form.

※Note: CSAJ strictly take care of your private information.
Email *
1. Have you ever registered with us before? *
2. Full Name (English) *
(Family name, given name in English Capital Letter, e.g. CHAN DARA)
3. ឈ្មោះ (ខ្មែរ)​ *
( E.g.  ចាន់​ តារា)​
4. Gender *
5. Date of Birth *
(DD/MM/YYYY, Example: 29/01/1990)
6. Email Address *
7. Phone Number
8. Date of Arrival in Japan *
(DD/MM/YYYY/ or if you don't remember the day, just MM/YYYY)
9. Prefecture of Residence in Japan *
10. Name of Current (or Expected) University/College/School *
(Example: Chiba University)
11. Field of Study *
(Example: Architecture, Civil Engineering, Business, Japanese Language...)
12. Grade of Study *
13. Expected Year and Month of Graduation *
(MM/YYYY or if you are not sure just the year YYYY)
14. Plan after graduation *
15. Name of Your Scholarship or Sponsor *
16. Home Address in Japan (optional) 
(For mailing purpose and emergency case), written in English or Japanese
18. Comment or suggestion to CSAJ
We also have CSAJ Facebook Group and Page as well as a Telegram Channel. 
Group: https://www.facebook.com/groups/csaj.org/
Page: https://www.facebook.com/csajpage/
Telegram Channel: https://t.me/+edmi4r6uHZU0NmVl 

If you have any questions, please contact us at: csaj.info@gmail.com

*** Note: If any of your information above (e.g. school, phone number, prefecture of residence) has changed, please update it by filling the form again from the beginning.
*** By filling in this form, you agree to have this information shared with the Royal Embassy of Cambodia in Japan. 

Thank you for your cooperation!
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