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日本语课程申请书
Japanese Course Application Form
东京ひろがり日本语学校
Tokyo Hirogari Japanese language school
Tel:（+81）42-850-9917 Email: info@hirogari.tokyo
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* Indicates required question
申请报名课程
Application course
*
On-line・通学 个别指导课程 Private Lesson（Online＋Offline）
参加试听课程 Trial Classes
Required
姓名（英文拼音名字）
Name (English notation)
*
Your answer
姓名（中文汉字名字）
Name (Kanji notation) ※Only for people in the Kanji area
*
Your answer
姓名（日语假名的拼音）
Name (katakana notation) ※ Only for those who can write katakana
Your answer
西元出生年月日
Date of birth
*
MM
/
DD
/
YYYY
国籍
Nationality
*
Your answer
居住地区（居住地非日本地区，可书写英文，或是中文）
Place of residence (English or Japanese notation)
*
Your answer
连络电话
Contact phone number
Your answer
e-mail 邮箱
*
Your answer
职业
Occupation
*
社会人士 Society
大学生丶专门学校生 niversity student / vocational school student
其他 Other
请问是否有参加过日本语能力试验（ JLPT ）？
If you have taken the Japanese Language Proficiency Test, please tell us the grade and whether you passed or failed.
N１
N２
N３
N４
N５
不合格 Not Pass
合格 Pass
没有报名参加过
N１
N２
N３
N４
N５
不合格 Not Pass
合格 Pass
没有报名参加过
在留资格（目前居住丶滞留於日本的签证资格）
Status of residence ( only for those staying in Japan )
Your answer
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