STUDYING JAPANESE
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Please check the appropriate box and respond to the following questionnaire.
I. Courses or Lessons
These are The CourseLevels we offer and please identify the type of Course you are attending.
A1 (Basic User A1) Monday 10:00-11:00
A1 (Basic User A1) Tuesday 18:30-19:30
A2 (Basic User A2) Wednesday 10:00-11:00
A2 (Basic User A2) Thursday 18:30-19:30
Other
You would like the course to begin on:
September
October
November
December
January
February
March
April
May
May
June
July
August
If you would prefer One-to-One Lessons, Desired days
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday or Sunday (by prior arrangement)
Times
10:00
11:00
13:00
14:00
15:00
16:00
17:00
18:00
19:00
Other
When to start:
September
October
November
December
January
February
March
April
May
June
July
August
Location:
Our school
Your home
Your office/school
Other
II. Questionnaire about Yourself
What is your gender?
Male
Female
Your mother tongue:
Foreign languages you speak:
Which of the following best describes your reason for taking the course?
to learn how to read & write
to master Japanese
to enjoy anime, manga or the like
Interest in Japanese culture
Requirement for admission to a college
to read Japanese magazines and books
necessary for business
to listen to Japanese pop music
to stay in Japan as a student
to talk with your Japanese friends/people
Other
Please indicate what you may be interested in as to Japan.
Language
Character (Chinese characters & Japanese phonetic characters)
Traditional arts
Flower arrangement
Tea ceremony
Calligraphy
Music
History
Economy
Fashion
Anime/manga
Novels
Movies
Japanese cooking/food
Travel
Hot Spring
Other
Have you ever studied Japanese language?
Yes
No
If you choose ‘Yes’ for the previous question, How long?
3 months
6 months
12 months
more than 12 months
Where?
University
Language school
Self-education
Other
What kind of textbooks did you use for study?
What is your current level of Japanese language?
Beginner
Intermediate
Advanced
Have you ever studied in Japan?
Yes
No
If yes, how long?
3 months
6 months
1 year
2 years
more than 2 years
How many times have you been to Japan for sightseeing?
none
once
twice
3 times
more than 3 times
If so, How long?
one week
10 days
2 weeks
more than 2 weeks
Please enter your contact information below.
Name
First
Last
Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Afghanistan
Albania
Algeria
Andorra
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Country
Phone
Email
Questions Comments you might have: