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【Aoyama Gakuin Univ[Sagamihara Campus]】Residence Application Form
●Applicant
Name
必須
First name
Last name
Furigana (Pronunciation)
必須
First name
Last name
Name in Japanese Katakana required
Gender
必須
Male
Female
Date of Birth (dd-mm-yyyy)
必須
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
day
01
02
03
04
05
06
07
08
09
10
11
12
month
year
Nationality
必須
Japan 日本
Others それ以外
Contact Number
Country Code
Phone Number
Email Address
必須
Home university
必須
Name
School Status
First-year student
Second-year student
Third-year student
Fourth-year student
Graduated
Department / School
(Current department/school)
Aoyama Gakuin Universiity
Department
Campus you belong to
Sagamihara
Aoyama
Japanese Level
Advanced
Intermediate
Beginner
●Emergency Contact
Name
必須
First name
Last name
Furigana (Pronunciation)
必須
First name
Last name
Relationship
必須
（Ex.: Father）
Nationality
必須
Japan 日本
Others それ以外
Contact Number
Country Code
Phone Number
Address
Check the checkbox if the same as the Applicant's above.
address
(others)
●Requests/Preferences
Dormitory Preferences
必須
Diakonia Hashimoto
Dormy Sagamiono
Contract Period
The contract end date is fixed on the 24th of each month.
Half-Year
Year
*The move-in date of the dormitory will be determined according to the school's schedule. We will contact you when the details are finalized.
until end of Spring semester : August 24
until end of Fall semester: February 24
*Please contact at [agu-aoyamacp@dormy.co.jp] if you wish to make changes due to the class schedule.
Meal plan
★ONLY Dormy Sagami-ono
with meals
without meals
*The difference between including/excluding meals is 5,000 yen.
*Special menus for allergy, vegetarian, vegan, or religious reasons are not available.
Payment Method (for a half year contract)
*Handling fees are incurred with each payment, so we recommend one-time payment.
*Credit card payment is not accepted.
Please note that the handling fee is at your own expense when paying at a convenience store or bank transfer.
Monthly
One Time Payment
* Initial Payment must be completed before moving-in by wire transfer.
* For those who select monthly or semi-annual payment, you can select from convenience store payments, bank transfers (both domestic and international), or automatic bank withdrawal (Japanese banks only and application required) after moving-in.
Payment Method (for a year contract)
*Handling fees are incurred with each payment, so we recommend one-time payment.
*Credit card payment is not accepted.
Please note that the handling fee is at your own expense when paying at a convenience store or bank transfer._copy
Monthly
Every six months
Once a year
* Initial Payment must be completed before moving-in by wire transfer.
* For those who select monthly or semi-annual payment, you can select from convenience store payments, bank transfers (both domestic and international), or automatic bank withdrawal (Japanese banks only and application required) after moving-in.
Bedding Rental
* Included Items in the Bedding Set:
Pillow, blanket, comforter, pillowcase, comforter cover, sheets and Shikibuton (Japanese futon mattress) for a wood slatted bed OR bed pad for a bed with a mattress.
You can change the sheets three times a month.
必須
6Months(\18,920)
12Months(\30,800)
No need
*Bedding lease fees are non-refundable after moving-in.
*If you do not request bedding, please purchase it by the day of check-in. (We do not accept baggage delivery before move-in. Please specify a date and time according to your move-in day)
Urethane Mattress
Yes
No
If you apply for it along with a bedding rental: 4,620 yen
If you want the urethane mattress only: 6,600 yen
Remarks
（Request /Questions)
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