Please Complete in English
|
Personal Information
|
|
Last Name: |
|
First Name:
|
|
Middle:
|
|
Gender:
|
|
|
Desired Field: |
|
|
If other, please specify |
|
Nationality:
|
|
|
If other, please specify |
|
Country of Current Residence:
|
|
|
City: |
|
|
State: (If in the United States) |
|
|
Postal Code: |
|
Phone Number:
|
|
Current occupation:
|
|
Degree:
|
|
If other, please specify
|
|
Major:
|
|
|
If other, please specify |
|
Visa Status:
|
|
If other, please specify
|
|
Visa Expiration: (mm/dd/yy)
|
|
Where did you hear about us?
|
Friends
Publication:
BaySpo
Beach Press HI
Bridge USA
Frontline
Gairai HI
Lighthouse
Nikkan San
CA Telephone Guide
Town Guide LA
US Town J
Yellow Pages
|
Websites:
Asia links
EDI home page
Google
PlanetEdu
Vault
Vivi Navi
Wetfeet
Other
|
What would you like to receive information
about?
|
J-Visa Professional Training:
Open Position
Priority Open Position
Visa Assistance
Internship & English:
Internship (Unpaid)
English classes
Dance & Voice:
Dance lessons
Optional Voice lessons
Optional English classes
|
School Introduction:
Cinema Make-up School
The International College of Pet Career
The Art Institute of California, SF
Other
Genchi Support Service (For Japanese students only):
Genchi Counseling /24hr Telephone Support
School Assistance/Support
Personal Support
American Life Orientation (SF/LA only)
|
Please provide a current e-mail address below. Information will
be sent to you shortly.
|
|
E-mail Address: |
|
|
