1. Applicant Details Name Address Tel E-mail Date of Birth Nationality Language Proficiency Occupation(School if you are a student) Visa Status 2.Residency Requirements (Please specify which room you want to stay) 3.Date you plan to move in and residency period 4.Outline your main goal during your stay in Japan 5.Any comments The personal information that you provide will be handled based on our company’s privacy policy. Please read it carefully before you submit.