Student information

EmailRequired

※Please register an address where you can always be reached. Be careful not to make any mistakes. If the student has their own email address, please provide it. If not, please provide the email address of the parent or guardian.

Date of birth

AgeRequired

Name of your current schoolRequired

GradeRequired

GenderRequired

Male Female Other

If you have certification of English proficiency, please fill in the latest record below. Example: Eiken Grade 3

Program you wish to attend

※Please refer to the website and the links above for details.

※We list the Eiken grade as a participation criterion lower than the standard criterion so that anyone can try it. This is a great opportunity to gain experience similar to studying abroad, so please apply.

Select the course of your choice (Daytime Session)Required

None CEFR A1（Equivalent to Eiken 5 to 4） CEFR A2（Equivalent to Eiken Pre-2 or higher） NS1 Maths（Equivalent to Eiken Pre-2 or higher） NS2 Maths（Equivalent to Eiken Pre-2 or higher） NS3 Maths（Equivalent to Eiken Pre-2 or higher） NS1 Science（Equivalent to Eiken Pre-2 or higher） NS2 Science（Equivalent to Eiken Pre-2 or higher） NS3 Science（Equivalent to Eiken Pre-2 or higher） NS1 English（Equivalent to Eiken Pre-2 or higher） NS2 English（Equivalent to Eiken Pre-2 or higher） NS1 Global Perspectives（Equivalent to Eiken Pre-2 or higher） NS1 ICT（Equivalent to Eiken Pre-2 or higher） NS1 PHSE（Equivalent to Eiken Pre-2 or higher）

Select the course of your choice (②April 1st - 4th, 2024) Required

None CEFR B1（Equivalent to Eiken 2 or higher） IGCSE English First Language（Equivalent to Eiken Pre-1 or higher） IGCSE English Second Language（Equivalent to Eiken 2 or higher） IGCSE Maths（Equivalent to Eiken 2 or higher） IGCSE Chemistry（Equivalent to Eiken 2 or higher） IGCSE Physics（Equivalent to Eiken 2 or higher） IGCSE Biology（Equivalent to Eiken 2 or higher）

Payment and Fees

※Please refer to the website for fees. Payment for the program fees is required in a lump sum. You can choose to pay by credit card or bank transfer. Payment details will be provided via email.

Payment methodRequired

Credit Card Bank Transfer

Parent/Guardian information

Full nameRequired

※アルファベットでご記入ください

Relationship with the student Required

Mother Father Other

If you selected "Other" for the relationship with the student, please specify the relationship below.

EmailRequired

※Please make sure to register an address where we can contact you.Please make sure you enter the correct address.

Contact (phone number)Required

Other Considerations

If there are any considerations such as the need for learning support or advice, or potential obstacles to learning, please fill in the details here.

Application Checklist

Please confirm the following and check all that apply. (Required)Required

Is the selected program suitable for the student's preferences and learning goals?

Have you provided information about English certification (if available) along with this application?

Notes for Attendance

For a more comfortable learning experience, we recommend attending the class with a laptop or higher. ※ Details will be provided in an email after registration.

Declaration and Signature

As the parent/guardian of the student, I agree to the following. (Please check all that apply.)Required

I understand that the information on this application form must be filled in accurately，and if incorrect information is provided，it may delay the enrollment process.

If applying through a school or educational institution，I understand that Nisai may share information with school officials.

I understand the contents of the course and the procedures for future attendance.

I understand that cancellations are accepted up to 4 days before the program start date (December 19st). I understand that no cancellations will be accepted after this date，regardless of the reason.

Date and Parent/Guardian's SignatureRequired

Input Allowed (Example: 2020/7/30 Yamada Taro)

Date and Student's SignatureRequired

Input Allowed (Example: 2020/7/30 Yamada Hanako)