Full Name
required
Sex
required
Male
Female
Date of Birth
required
01
02
03
04
05
06
07
08
09
10
11
12
Month
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
Year
Email Address
required
For confirmation
Phone Number
required
-
-
Address
required
Prefectures
City
Street Address
Apartment Name
Room Number
Nationality
required
Residence status
required
Permanent Resident
Japanese Spouse
Long-Term Resident
Permanent Resident Spouse
The Japanese understanding to think about by oneself?
required
100
80
60
40
20
0
%
confirm
