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Inquirer Information [* Fields Required] |
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Name of Inquirer* |
Last Name*
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First Name*
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Middle Name
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Title* |
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Email* |
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Phone |
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Fax |
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Relationship with Student* |
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Student Information - I
[If inquirer is not same person as student, fields with asterisk (＊) are required.] |
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Name of Student* |
Last Name*
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First Name*
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Middle Name
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Gender* |
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Email* |
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Phone |
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Fax |
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Student Information - II [Fields with asterisk (*) are required.] |
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Name of School Currently Attending |
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Current Grade |
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Grade Considering* |
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Intake Considering* |
Year Month |
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Questions |
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Brochure Request [Required] |
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Yes, send me a copy of school brochure to my address below. |
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No thanks. |
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Mailing Address
[If you are requesting the brochure, fields with asterisk (*) are required.] |
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Post Code* |
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Country* |
i.e.) Japan, Canada
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Prefecture, State or Province* |
i.e.) Tokyo, British Columbia
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City* |
i.e.) Shinagawa-ku, Vancouver
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Street Address* |
i.e.) 5-8-20 Kitashinagawa
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Name of Building etc. |
i.e.) A31 CIS Bldg.
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Newsletter Subscription [Required] |
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Would you like to receive the school publications such as the campus newsletter via post? |
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Yes, I would. No, thanks. |
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Would you like subscribe the online newsletter and receive it at your email address? |
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Yes, I would. No, thanks. |
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