Course Registration Form (SG)

Student Registration Form

Fill out the form carefully for registration
★This is the form for students who live in Singapore or the same time zone as Singapore.
★If you live in the United States, please use the link below.
https://form.jotform.com/yotsubajapanese/course-registration-form

★If you live other than the countries above, please contact yotsuba.japanese@gmail.com to confirm the class schedule.
Please Choose*

New StudentContinuing Student
Student Name*

PrefixFirst NameLast Name
Parent of Guardian Name (If a student under 18)

PrefixFirst NameLast Name
Birth Date*

DayMonthYear
Gender*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
example@example.com
Alternative E-mail
example@example.com
Mobile Number*

Country CodePhone Number
Home Number

Country CodePhone Number
Company or School Name
Courses
Courses*

Basic 1 - Start on Thur. 16 Jan. 2025 (75 mins x 10 lessons)Private Lesson for Kids (30 mins)Private Lesson (45 mins)Private Lesson (60 mins)Private Lesson (90 mins)Easy Travel Japanese (25 mins x 5 lessons)Conversation Class - Intermediate (60 mins)Single Class (25 mins)Single Class (45 mins)Single Class (60 mins)
Please answer the below only a new student.
1) Have you ever learned Japanese before? If yes, how long have you learned?
2) How did you learn? (e.g., College, Language School, Online lesson...)
3) Which textbook did you use?
4) Are you confident to read and write HIRAGANA, KATAKANA, or any Kanji?
5) Have you ever tried JLPT? If yes, what level did you pass?
6) What is the purpose of learning Japanese?
7) How did you know about our school?
Additional Comments
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Student Registration Form