Registration-Form

ASIJELC (Roppoingi Hills) (A.S.I.J.E.L.C. students only)

Tue. 2:30 – 3:15pm 3 to 6yrs / Beginner Sept 2019~June 2020 (Term) / 90,000 yen / max 15 students / 3 to 6 year olds
Thu. 2:30 –3:15pm 4 to 6yrs / Activities Sept 2019~June 2020 (Term) / 87,000 yen / max 12 students / 4 to 6 year olds (pre-K and kindergarteners only

British School in Tokyo (Shibuya) (B.S.T. students only)

Fri. 7:30 – 8:20pm Y1 to Y3 / Beginners and Adv. Beg. September~December 2019 / 36,000 yen / max 14 students

International School of Sacred Heart (Hiroo)

Sat. 9:00 – 9:50am 6 to 10yrs / Adv. Beg.
Sat. 9:55 – 10:55am 6 to 10yrs / Adv. Beg.
Sat. 11:00 – 12:00pm 6 to 10yrs / Adv. Beg.

Nishimachi International School (Moto Azabu)

Mon. 5:45 – 6:45pm 6 to 10yrs / Adv. Beg.
Thu. 6:00 – 7:00pm 6 to 10yrs / Adv. Beg.
Sun. 9:35 – 10:20am Walking to 3yrs(with Parents) / Tiny Tots
Sun. 10:25 – 11:25am 4 to 6yrs / Beginner
Sun. 11:30 – 12:30pm 6 to 10yrs / Adv. Beg.

Mitsubishi UFJ Bank / Hiroo Branch
Futsu (Ordinary) Account
Account No. 0892389
Account holder: IGC Japan Yugen Kaisha
**Domestic transactions only – no transfers from outside Japan**

STUDENT INFO

First Name*

Last Name*

Sex*

B-day (yyyy/mm/dd*

*Please input in form of "yyyy/mm/dd" Eg.) February 4th,1995 will be 1995/02/04

Age*

Email*

Eg.) example@igcjapan.com

Nationality*

School Name*

PARENT'S INFORMATION

Title*

First Name*

Last Name*

Cellphone#*

Eg.) 090-xxxx-xxxx

Email*

Eg.) example@igcjapan.com

Company*

Office Tel*

Eg.) 03-xxxx-xxxx

B-day (yyyy/mm/dd)*

*Please input in form of "yyyy/mm/dd" Eg.) February 4th,1995 will be 1995/02/04

PARENT'S INFORMATION 2 - Please fill in "NA" if inapplicable.

Title*

First Name*

Last Name*

Cellphone#*

Eg.) 090-xxxx-xxxx

Email*

Eg.) example@igcjapan.com

Company*

Office Tel*

Eg.) 03-xxxx-xxxx

B-day (yyyy/mm/dd)*

*Please input in form of "yyyy/mm/dd" Eg.) February 4th,1995 will be 1995/02/04

GENERAL INFO

Postal #*

Eg.) 106-xxxx

Prefecture*

City*

Address1*

Address2

Home Phone #*

Eg.) 03-xxxx-xxxx

TAC MEMBER #

Has your child ever been a part of the I CAN. program?*

Yes
No

If yes, please specify class

How did you find out about us?*

Internet/Website
From friend
School
Other

Please let us know how you found us.

Comments

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