SIL Sapporo Nihongo Gakko

Boarding house Application

As I start my boarding house stay I agree to the following conditions:

to pay the full fee in advance;
to dispose of each kind of garbage (burnable/non-burnable) on the designated day;
to keep the room clean and remove all trash;
to pay the full cost of any damaged items;
I understand that the room is for the benefit of my Japanese learning and that only the person/persons who signed the contract to stay in the room are allowed to stay.

I would like to apply for a boadinghouse stay during:

A name of a borading house and 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:

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