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Admission Application Form – Shukugawa Kindergarten

Thank you for applying to our kindergarten.
To help us process your application smoothly, please complete the form below.
Student Information
Photo of Student必須
10Mバイトまで 複数ファイルを送るには
Upload a clear photo of your child (face visible). Max 10MB.
Full Name (in English)必須
First Name 
Last Name 
Name in Native Language (if applicable)
Date of Birth (MM/DD/YYYY)必須
 M  D  Y 
Age必須
 years old   
Grade必須
Gender必須
Native Language必須
Home Address必須
〒－ 
都道府県
市区町村
町名番地等
建物名
Current School
Current Kindergarten / Nursery School必須
* Enter “None” if not currently attending a school.
English Experience
Has your child studied English before?必須
Experience in learning English必須
International School or English Conversation School必須
Duration (_years _months)必須
Other English Learning Experience必須
Duration (_years _months)必須
Why did you choose our school?必須
What do you expect from our school?必須
Admission & Attendance
Preferred Start Date (MM/DD/YYYY)必須
 M  D  Y 
Preferred Attendance必須
Days of Attendance (check all that apply)_4必須
If your child does not attend on certain weekdays, how will they spend that time?_4必須
Days of Attendance (check all that apply)_3必須
If your child does not attend on certain weekdays, how will they spend that time?_3必須
Who will usually pick up your child? (Name & Relationship)必須
In case of urgent pickup or emergency, who should we contact? (Name & Relationship)必須
Parent/Guardian Information 1 (Primary Contact)
Tuition Payment Method必須
Extended Care Preference必須
* Selecting an option here does not constitute a final commitment.
Daycare Pack Usage

Please indicate your current preference. The official application will be completed at the time of contract.
Daycare Pack – Usage Preference必須
Preferred Package Plan必須
Parent/Guardian Information 1 (Primary Contact)
P1/ Full Name (English)必須
First Name 
Last Name 
P1/ Name in Native Language (if applicable)
P1/ Relationship to Child必須
P1/ Gender必須
P1/ Native Language必須
P1/ Phone Number (Daytime contact)必須
 -  - 
This number will be used for daily school communication (attendance, belongings, student matters). Please enter a number where you can be reached during the day.
P1/ Email Address (Primary)必須
This will be your main contact, login ID for the Parent Portal, and the address for invoices.

Re-enter for Confirmation
Would you like to receive arrival/departure notifications at this address?
P1/ Email Address (Secondary)

Re-enter for Confirmation
Receive pick-up/drop-off notifications at this address?
P1/ Home Address (if different from student’s address)
〒－ 
都道府県
市区町村
町名番地等
建物名
P1/ Employer/Company Name必須
Parent/Guardian Information 2 (Optional)
P2/ Full Name (English)
First Name 
Last Name 
P2/ Name in Native Language (if applicable)
P2/ Relationship to Child
P2/ Gender
P2/ Native Language
P2/ Phone Number (Daytime contact)
 -  - 
This number will be used for daily school communication (attendance, belongings, student matters). Please enter a number where you can be reached during the day.
P2/ Email Address (Primary)

Re-enter for Confirmation
Would you like to receive arrival/departure notifications at this address?
P2/ Email Address (Secondary)

Re-enter for Confirmation
Would you like to receive arrival/departure notifications at this address?
P2/ Home Address (if different from student’s address)
〒－ 
都道府県
市区町村
町名番地等
建物名
P2/ Employer/Company Name
Emergency Contact (Optional)

If neither Parent/Guardian 1 nor 2 can be reached in an emergency, please provide an alternate contact.
Emergency/Phone
 -  - 
Emergency/Name
Emergency/Relationship
Sibling Information
Sibling1/ Currently Enrolled at Our School必須
Sibling1/ Program at Our School必須
Sibling1/ Grade必須
Siblin1g/ Name (in English)必須
First Name 
Last Name 
Sibling1/ Name in Native Language (if applicable)必須
Sibling2/ Program at Our School
Sibling2/ Grade
Sibling/ Name (in English)
First Name 
Last Name 
Sibling2/ Name in Native Language (if applicable)
Sibling1/ Grade必須
Sibling1/ Name (in English)必須
First Name 
Last Name 
Sibling1/ Name in Native Language (if applicable)必須
Sibling2/ Grade
Sibling/ Name (in English)
First Name 
Last Name 
Sibling2/ Name in Native Language (if applicable)
Sibling’s Current School (Kindergarten / Nursery / Elementary)必須
About the Student
Normal Body Temperature必須
 ℃  
Does your child take any regular medication?必須
Name of Medication必須
Frequency / Dosage必須
Does your child have any allergies?必須
Type of allergies (Check all that apply)必須
Other Allergies / Food Restrictions必須
If your child requires any accommodations at school due to allergies, please describe them.必須
Our school may provide snacks and use various materials in class. Please let us know of any precautions, even minor ones, or foods that should not be given to your child.
Does your child have any chronic medical conditions?必須
Type of chronic medical conditions (Check all that apply)必須
Other chronic medical conditions必須
If your child requires any accommodations at school due to a chronic condition, please describe them必須
Questions / Comments
Agreement & Consent
Parent/Guardian Name (Signature)必須
By signing below, I agree to the terms outlined in the Privacy Policy regarding the handling of personal information.
First Name 
Last Name 
Handling of Personal Information (Privacy Policy)

Tokyo International School Group Co., Ltd. Administration Office (hereinafter the “Administration Office”) collects and uses personal information from customers (hereinafter “Customers”) interested in the Tokyo International School After-School business and related services (hereinafter the “Services”). The following explains how such information is handled.

1. Definition of Personal Information
For this Privacy Policy, “Personal Information” means information about Customers as defined in Article 2, Paragraph 1 of the Act on the Protection of Personal Information of Japan, including:
(1) Information for Service registration, such as name, address, date of birth, telephone number, email address, login ID, etc.
(2)Information from inquiries with the Administration Office by email, phone, fax, letters, etc., and related responses.

2. Purpose of Use of Personal Information
The Administration Office uses Personal Information for the following:
(1) To provide the Services.
(2) To send information and notices.
(3) To respond to inquiries.
(4) To develop new services and improve existing ones.
(5) To provide information on seminars, exhibitions, and new products.
(6) To distribute educational and PR materials, and other related information.
(7) For joint use as described in Section 3.

3. Provision of Personal Information to Third Parties
Except as described in Section 3 and in the cases below, the Administration Office will not provide Personal Information to third parties:
(1) With prior consent.
(2) When required by law.
(3) When necessary to protect life, health, or property of the individual or public.
(4) When necessary for business, such as entrusting tasks to partners, contractors, or professionals (attorneys, tax accountants, certified public accountants, etc.).
(5) When disclosure is ordered by a court or government authority.
(6) When business succession occurs due to merger, transfer, or other reasons.
コメント4. Outsourcing of Personal Information Handling
When outsourcing the handling of Personal Information for the purposes in Section 2, the Administration Office will entrust such work only to cooperating companies (contractors) that meet its selection standards. The Administration Office will set handling rules, provide proper guidance and supervision, enter into agreements on outsourced services, and ensure appropriate confidentiality management.

5. Disclosure, Correction, Deletion, etc. of Personal Information
If the individual subject of Personal Information requests disclosure, correction, suspension of use, or deletion in accordance with law, the Administration Office will verify identity and respond. Requests must be made using the form prescribed by the Administration Office.

6. Contact Information
For questions regarding the handling of Personal Information, please contact:

Operating Company: Tokyo International School Group Co., Ltd.
Ichigo Meguro Building 6F, 2-20-28 Shimomeguro, Meguro-ku, Tokyo, Japan
Personal Information Protection Manager: Ryo Tsuboya
TEL: 03-6421-7110