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HugMeInternationalSchool入園願書
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Email
*
Your email
入園希望の園
Which campas
*
HAMAMATSU
YOKOHAMA
Student Information
お子様について
Name （Japanese)
*
Your answer
Name （English）
*
Your answer
Gender 性別
*
Choose
M 男
F 女
Nationality 国籍
Your answer
Date of birth 生年月日
*
MM
/
DD
/
YYYY
Current Residential Address in Japan 現住所
*
Your answer
Tel 電話番号
*
Your answer
Proposed Enrolment Date 入園希望時期
*
MM
/
DD
/
YYYY
Special Circumstances
Has your child received or currently receiving any of the following?
下記のサポートを受けたことがある、または現在受けていますか？
Individual behavior management support 品行・行動上の問題についてのサポート
*
Yes
No
Required
Speech/Language therapy 言語治療
*
Yes
No
Required
Occupational therapy 運動機能治療
*
Yes
No
Required
Special resource center support 特別なサポートセンターの利用
*
Yes
No
Required
Special needs or learning support 特別な学習サポート
*
Yes
No
Required
Health Check
Please check all of the following questions and answer as applicable. 下記質問についてすべてお答えください。
Does your child have an allergy? アレルギーの有無
*
Yes
No
Required
Name of Allergy アレルギー名
Your answer
Has your child ever experienced an anaphylactic shock? アナフィラキシーショックの有無
*
Yes
No
Required
Does your child use an EpiPen? エピペンの有無
*
Yes
No
Required
Has your child ever experienced a fever seizure? 熱性痙攣の有無
*
Yes
No
Required
Chronic disease 持病
Your answer
Are there any other previous disease that should be noted? 過去の特記すべき病気
Your answer
Has your child received a periodic health check-up and vaccination? 定期健診・予防接種は受けていますか？
*
Yes
No
Required
Additional Information その他特記事項
Your answer
Child's Personality お子様の性格について
Please describe your child's personality お子様の性格について教えてください
*
Your answer
時間外利用・スクールバスについて
早朝保育
*
Choose
有
無
延長保育
*
Choose
有
無
Motive 志望動機
志望理由
*
Your answer
Educational History
Please list all schools attended これまでに通った学校名をすべて記入してください。
Your answer
Parent Information 保護者
Relationship 関係
*
父
母
Required
Name 氏名
*
Your answer
Tel
*
Your answer
Occupation 職業
*
Your answer
Company name 会社名
*
Your answer
Relationship 関係
父
母
Name 氏名
Your answer
Tel
Your answer
Occupation 職業
Your answer
Company name 会社名
Your answer
Siblings 兄弟姉妹
Name/Age/School 氏名/年齢/学校名
Your answer
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