Weekly Apartment Application


As I start my apartment stay I agree to the following conditions:


I would like to apply for an apartment stay during:



Notes:

cf.Courses page


Name:

male female

Date of Birth:

Nationality:

Current Mailing Address (Include street, city, postal code, and country):

Phone Number:

Fax Number:

E-mail Address:

In the event of an emergency, please provide us with your parent's (or other) names, address, and phone number:

Arrival date and time:
Departure date and time:

Room type:

I would like a room with a Futon.
I would like a room with a refrigerator.
I would not like to borrow any kitchen utensils.


Rental items: Check the items you would like to rent.


Item Cost
Microwave Oven \2,000
Bed \2,000
Table and chairs \2,000
Toaster Oven \1,000
TV \1,000
Plastic Drawers \1,000


Please be sure to click the submit button once after filling in the form and send the appropriate application fee and a photo to SIL.
If you have trouble emailing this application, print it out and mail to SIL with your application fee.


SIL Sapporo Nihongo Gakko
Director & Instructor Ms. Harumi Shima
Bell Idaimae 1F, 291 Nishi 18 chome Minami 2 jo Chuo ku
Sapporo JAPAN 060-0062 Tel/Fax: 81-011-614-1101
E-mail: info@silnihongo.com